Potassium clavulanate is a novel β-lactamase inhibitor, which, in combination, expands the spectrum of amoxicillin to include many amoxicillin-resistant organisms. Potassium clavulanate is excreted 30–50 percent unchanged renally and its plasma time-course parallels that of amoxicillin. Several studies suggest that an increased incidence of gastrointestinal side effects may occur with this combination. In the current oral formulation, its greatest utility may be in pediatric infections due to β-lactamase-producing Haemophilus influenzae and B. cattarhalis. In adults, the combination has not been adequately studied against other effective antibiotics.
RolinsonGN. History and mode of action of Augmentin. Postgrad Med1984; 76 (suppl):25–8.
2.
NeuHCFuKP. Clavulanic acid, a novel inhibitor of β-lactamases. Antimicrob Agents Chemother1984; 14: 650–5.
3.
NeuHC. Beta-lactamases: A perspective on the contribution of these enzymes to bacterial resistance. Postgrad Med1984; 76 (suppl):7–21.
4.
FuchsPCBarryALThornsberryC. In vitro evaluation of Augmentin by broth microdilution and disk diffusion susceptibility testing: Regression analysis, tentative interpretative criteria, and quality control limits. Antimicrob Agents Chemother1983; 24: 31–8.
5.
SlocombeBBealeABoonR. Antibacterial activity in vitro and in vivo of amoxicillin in the presence of clavulanic acid. Postgrad Med1984; 76 (suppl):29–49.
6.
GirouardYCMacLeanIWRonaldAPAlbrittonWL. Synergistic antibacterial activity of clavulanic acid and amoxicillin against beta-lactamase-producing strains of Haemophilus ducreyi. Antimicrob Agents Chemother1981; 20: 144–5.
7.
HuntedPAColemanKFisherJTaylorD. In vitro synergistic properties of clavulanic acid, with ampicillin, amoxicillin and ticarcillin. J Antimicrob Chemother1980; 6: 455–70.
8.
VanlanduytHWPyckavetMLambertAM. Comparative activity of BRL-2500 with amoxicillin against resistant clinical isolates. J Antimicrob Chemother1981; 7: 65–70.
9.
JacksonDCooperDLFillerCWLangleyPF. Augmentin: Absorption, excretion and pharmacokinetic studies in man. Postgrad Med1984; 76 (suppl):51–70.
10.
AdamDDevisserIKoppeP. Pharmacokinetics of amoxicillin and clavulanic acid administered alone and in combination. Antimicrob Agents Chemother1982; 22: 353–7.
11.
DaigneaultEAFerslewKERosemanJMAtenEM. Comparison of the pharmacokinetics and urinary excretion of clavulanic acid after oral administration of Augmentin using high performance liquid chromatographic and microbiologic assays. Postgrad Med1984; 76 (suppl):169–75.
12.
StaniforthDHLillystoneRJJacksonD. Effect of food on the bioavailability and tolerance of clavulanic acid/amoxicillin combination. J Antimicrob Chemother1982; 10: 131–9.
13.
MunchRLuttyRBlaserJSiegenthalerW. Human pharmacokinetics and CSF penetration of clavulanic acid. J Antimicrob Chemother1981; 8: 29–37.
14.
NelsonJDKusmieszHSheltonS. Pharmacokinetics of postassium clavulanate in combination with amoxicillin in pediatric patients. Antimicrob Agents Chemother1982; 21: 681–2.
15.
MartinelliRAlbertoADa SilvaLopes A. Amoxicillin-clavulanic acid in treatment of urinary tract infection due to gram-negative bacteria resistant to penicillin. Antimicrob Agents Chemother1981; 20: 800–2.
16.
FancourtGJMattsSGMitchelCJ. Augmentin (amoxicillin-clavulanic acid) compared with co-trimoxazole in urinary tract infection. Br Med J1984; 289: 82–3.
17.
GurwithMJSteinGEGurwithD. Prospective comparison of amoxicillin-clavulanic acid and cefaclor in treatment of uncomplicated urinary tract infections. Antimicrob Agents Chemother1983; 24: 716–9.
18.
MadsenPODorflingerTFrimodt-MollerP. Augmentin and cefaclor in treatment of complicated urinary tract infections. A comparative study. Postgrad Med1984; 76 (suppl): 191–5.
19.
LeighDABradnockKMarriwerJM. Augmentin (amoxicillin and clavulanic acid) therapy in complicated infections due to beta-lactamase producing bacteria. J Antimicrob Chemother1981; 7: 229–36.
20.
IravaniARichardGA. Treatment of urinary tract infections with a combination of amoxicillin and clavulanic acid. Antimicrob Agents Chemother1982; 22: 672–7.
21.
CrokaertFVan der LindenMPYourassowskyE. Activities of amoxicillin and clavulanic acid combinations against urinary tract infections. Antimicrob Agents Chemother1982; 22: 346–9.
22.
BrumfittWHamilton-MillerJMT. Amoxicillin plus clavulanic acid in the treatment of recurrent urinary tract infections. Antimicrob Agents Chemother1984; 25: 276–8.
23.
NakazawaHHashimotoTNishiuraTSusumuM. Efficacy of BRL-2500 against Serratia marcescens, Enterobacter cloacae, and Citrobacter freundii in urinary tract infections. Antimicrob Agents Chemother1983; 24: 437–9.
24.
BallAPDaveyPGGeddesAM. Clavulanic acid and amoxicillin: A clinical, bacteriological, and pharmacological study. Lancet1980; 1: 620–3.
25.
Tolkoff-RubinNRubinRWeberDT. Augmentin in the treatment of urinary tract infection. Postgrad Med1984; 76 (suppl):79–85.
26.
FaroSPastorekJAldridgeK. Open efficacy of tolerance study of Augmentin in the treatment of urinary tract infections. Postgrad Med1984; 76 (suppl):195–8.
27.
SnavelySRHarmsJLHinthornDRLiuC. Efficacy of amoxicillin-potassium clavulanate in the treatment of urinary tract infections. Postgrad Med1984; 76 (suppl):213–7.
28.
LernerSLyonESWaldVC. The treatment of urinary tract infections with amoxicillin/potassium clavulanate (Augmentin). Postgrad Med1984; 76 (suppl):225–8.
29.
JaffeACO'brienCALemonE. Clinical experience with Augmentin in a pediatric outpatient setting. Postgrad Med1984; 76 (suppl):199–211.
30.
FleisherGScottPWilmottCCamposJ. Amoxicillin combined with clavulanic acid for the treatment of urinary tract infections in children. Postgrad Med1984; 76 (suppl):219–24.
31.
DambroNFriedmanADAlexanderERHarrisonHR. Augmentin therapy for urinary tract infections in children. Postgrad Med1984; 76 (suppl):263–6.
32.
GoldsteinEJReinhardtJRMurrayPMFinegoldSM. Animal and human bite wounds: A comparative study, Augmentin versus penicillin ± dicloxacillin. Postgrad Med1984; 76 (suppl):105–10.
33.
AtenEMNeuHC. A multi-center, double-blind comparative study of amoxicillin/clavulanic acid and cefaclor in the treatment of skin and skin structure infections. Postgrad Med1984; 76 (suppl):147–55.
34.
QuinnELCardenasJVPohlodD. Treatment of skin and soft tissue infections with amoxicillin/clavulanic acid or cefaclor. Postgrad Med1984; 76 (suppl):97–104.
35.
HansenRA. Double-blind efficacy and tolerance study of amoxicillin-clavulanic acid and cefaclor in the treatment of skin and skin structure infections. Postgrad Med1984; 76 (suppl):239–43.
36.
PienF. Double-blind comparative study of two dosage regimens of cefaclor and amoxicillin-clavulanic acid in the outpatient treatment of soft tissue infections. Antimicrob Agents Chemother1983; 24: 856–9.
37.
RisserWLJaffeACBrombergK. A review of treatment of skin and soft tissue infections in children with amoxicillin-clavulanic acid combination or cefaclor. Postgrad Med1984; 76 (suppl):245–50.
38.
BrombergKWorkuMGullansCRSierraMF. Augmentin (amoxicillin/potassium clavulanate) for the therapy of pediatric skin and soft tissue infections. Postgrad Med1984; 76 (suppl):235–8.
39.
FleisherGRWilmottCMCamposJM. Amoxicillin combined with clavulanic acid for the treatment of soft tissue infections in children. Antimicrob Agents Chemother1983; 24: 679–81.
40.
SeidenfeldJJ. A double-blind trial of amoxicillin and clavulanic acid versus cefaclor in adult patients with lower respiratory tract infection. Postgrad Med1984; 76 (suppl):177–81.
PennRLManochaKLBurfordJGGeorgeRB. Prospective comparison of Augmentin and cefaclor as therapy for lower respiratory tract infections. Postgrad Med1984; 76 (suppl):251–5.
43.
TanJSFileTM. Double blind efficacy of safety of Augmentin versus cefaclor in the treatment of lower respiratory tract infection. Postgrad Med1984; 76 (suppl):129–31.
44.
GoochWMCongeniBLSwensonESnellmanLW. Oral Augmentin in the management of pediatric pneumonia. Postgrad Med1984; 76 (suppl):187–9.
45.
AronovitzGH. Safety and efficacy of Augmentin in the treatment of streptococcal pharyngitis. Postgrad Med1984; 76 (suppl):257–8.
46.
WaldERReillyJSCasselbrantMCChiponisDM. Treatment of acute sinusitis in children: Augmentin versus cefaclor. Postgrad Med1984; 76 (suppl):133–6.
47.
BluestoneCD. Augmentin therapy for acute otitis media in children: Summary of presentation from four clinical trials. Postgrad Med1984; 76 (suppl):137–9.
48.
De KonigGATioDCosterJF. The combination of clavulanic acid and amoxicillin (Augmentin) in the treatment of patients infected with penicillinase producing gonococci. J Antimicrob Chemother1981; 8: 81–2.
49.
FastMVD'costaLJKarasiraP. Treatment of chancroid by clavulanic acid with amoxicillin in patients with beta-lactamase-positive Haemophilus ducreyi infection. Lancet1982; 2: 509–11.
50.
CroydonP. Worldwide clinical review of Augmentin. Postgrad Med1984; 76 (suppl):71–8.
