Dosage Forms and Strengths

Augmentin is available in various dosage forms and strengths. The common forms include tablets, chewable tablets, oral suspension, and extended-release tablets. Each form comes in different dosage strengths. The standard tablets are available in 250 mg, 500 mg, and 875 mg strengths of amoxicillin, combined with 125 mg of clavulanic acid. Chewable tablets typically come in 200 mg/28.5 mg and 400 mg/57 mg strengths. Oral suspension is available in varying concentrations such as 125 mg/31.25 mg per 5 ml, 200 mg/28.5 mg per 5 ml, 250 mg/62.5 mg per 5 ml, and 400 mg/57 mg per 5 ml. Extended-release tablets usually come in a 1000 mg/62.5 mg strength.

Pharmacological Class

Augmentin belongs to the beta-lactam antibiotic class. It is a combination of amoxicillin, a penicillin-type antibiotic, and clavulanic acid, a beta-lactamase inhibitor. This combination broadens the spectrum of bacterial eradication. Amoxicillin works by inhibiting bacterial cell wall synthesis. Clavulanic acid, on the other hand, inhibits beta-lactamase enzymes produced by certain bacteria that can inactivate amoxicillin.

Mechanism of Action

The mechanism of action involves two key components. Amoxicillin disrupts bacterial cell wall synthesis by binding to penicillin-binding proteins. This leads to cell lysis and bacterial death. Clavulanic acid prevents bacterial resistance to amoxicillin by inhibiting beta-lactamase enzymes. This dual action makes Augmentin effective against a broader range of bacteria, including those that have developed resistance to standard penicillins.

Indications and Usage

Augmentin is indicated for the treatment of various bacterial infections. These infections include sinusitis, pneumonia, bronchitis, urinary tract infections, and skin infections. The medication is also effective against otitis media and lower respiratory tract infections. Augmentin is not suitable for viral infections like the common cold or influenza. The prescribing physician should confirm bacterial infection before prescribing this medication.

Dosage and Administration

The dosage of Augmentin depends on the severity and type of infection. For adults and children over 40 kg, the typical dosage is one 500 mg/125 mg tablet every 12 hours or one 875 mg/125 mg tablet every 12 hours. In severe infections, the dosage may be increased to one 875 mg/125 mg tablet every 8 hours. For children under 40 kg, the dosage is usually calculated based on body weight. Specific pediatric formulations are available for easier administration. Extended-release tablets are typically taken every 12 hours, with or without food. It is advisable to complete the prescribed course even if symptoms disappear to prevent bacterial resistance.

Drug Interactions

Augmentin may interact with other medications. It can increase the effects of anticoagulants like warfarin, leading to an increased risk of bleeding. It may reduce the efficacy of oral contraceptives, necessitating additional contraceptive measures. Co-administration with allopurinol increases the risk of amoxicillin-induced skin rashes. Probenecid can increase serum concentrations of amoxicillin by decreasing its renal excretion. These interactions require careful monitoring and possible dosage adjustments by the prescribing physician.

Adverse Reactions

Common adverse reactions to Augmentin include gastrointestinal disturbances like nausea, vomiting, and diarrhea. Some patients may experience allergic reactions such as rash, itching, and swelling. Serious but rare adverse effects include hepatic dysfunction, cholestatic jaundice, and acute liver failure. Cases of Clostridium difficile-associated diarrhea have also been reported. Patients should be advised to contact healthcare providers immediately if severe side effects occur.

Contraindications

Augmentin is contraindicated in patients with a history of severe allergic reactions to beta-lactam antibiotics. This includes penicillins and cephalosporins. Patients with a history of liver dysfunction associated with prior use of Augmentin or amoxicillin/clavulanic acid should avoid this medication. It is also contraindicated in patients diagnosed with mononucleosis, as the use of amoxicillin can result in a rash that closely mimics allergic reactions.

Special Populations

Pregnant women should use Augmentin only if clearly needed and under the guidance of a healthcare provider. Limited data suggest potential risks, so the benefits must outweigh these risks. Nursing mothers should exercise caution, as small amounts of the drug may be excreted in breast milk. For elderly patients, dosage adjustments may be necessary due to age-related renal impairment. Pediatric doses must be carefully calculated based on weight to avoid underdosing or overdosing.

Storage and Handling

Store Augmentin tablets at room temperature, between 20°C and 25°C (68°F and 77°F). The oral suspension should be stored in the refrigerator and discarded after 10 days. The medication should be kept in its original packaging to protect it from moisture and light. Ensure it is kept out of reach of children to prevent accidental ingestion. Do not use expired medication and properly dispose of any unused quantities according to local regulations.