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Co-amoxiclav.

VOL: 101, ISSUE: 26, PAGE NO: 29

Generic and proprietary names

 

Generic and proprietary names
- Co-amoxiclav.

 

 

- Augmentin, Augmentin-Duo.

 

 

Action
- An antibiotic that combines amoxicillin and clavulanic acid. It destroys bacteria by disrupting their ability to form cell walls.

 

 

- Clavulanic acid blocks the chemical defence, known as beta-lactamase, that some bacteria have against penicillins. l Co-amoxiclav is active against bacterial infections that have become resistant to amoxicillin.

 

 

Classification
- Broad-spectrum penicillin.

 

 

Indications
- Known or suspected amoxicillin-resistant infections including respiratory tract, skin and soft tissue, genitourinary, and ear, nose and throat infections.

 

 

- Effective against strains of Escherichia coli, Proteus mirabilis, Haemophilus influenzae, Streptococcus faecalis, Streptococcus pneumoniae and some beta-lactamase-producing organisms.

 

 

Contraindications
- Penicillin hypersensitivity.

 

 

- History of co-amoxiclav-associated or penicillin-associated jaundice or hepatic dysfunction.

 

 

Cautions
- History of allergy.

 

 

- Renal impairment.

 

 

- Erythematous rashes common in glandular fever.

 

 

- Cytomegalovirus infection.

 

 

- Acute or chronic lymphocytic leukaemia.

 

 

- Hepatic impairment.

 

 

- Pregnancy.

 

 

- Cholestatic jaundice.

 

 

Common side-effects
- Hepatitis.

 

 

- Cholestatic jaundice.

 

 

- Erythema multiforme (including Stevens-Johnson syndrome).

 

 

- Toxic epidermal necrolysis.

 

 

- Exfoliative dermatitis.

 

 

- Vasculitis.

 

 

- Dizziness.

 

 

- Headache.

 

 

- Convulsions (especially in high doses or in renal impairment).

 

 

- Superficial teeth staining when using the suspension.

 

 

- Phlebitis at injection site.

 

 

Rare side-effects
- Prolonged bleeding.

 

 

Administration
- Oral: tablets and suspension.

 

 

- Intravenous injection.

 

 

Nursing considerations
- Assess bowel pattern before and during treatment as pseudomembranous colitis may occur.

 

 

- Report haematuria or oliguria as high doses can be nephrotoxic.

 

 

- Assess respiratory status.

 

 

- Observe for anaphylaxis.

 

 

- Ensure that the patient has adequate fluid intake during any diarrhoea attack.

 

 

Patient teaching
- If the patient develops a rash, wheezing, itching, fever or swelling in the joints, this could indicate an allergy and should be reported.

 

 

- Patients must ensure they take the full course of the medicine.

 

 

- The medicine must be taken in equal doses around the clock to maintain level in the blood.

 

 

- If oral contraceptives are used, use alternative contraception.

 

 

- Report diarrhoea, cramping and blood in stools as pseudomembranous colitis may occur.

 

 

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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