"Amoxiclav 625": instructions for use, reviews, analogues

Among the antimicrobial agents of the drug "Amoxiclav 625" reviews of patients and experts are most indicative. The medicine is considered to be the most massive antibiotic and therefore it deserved wide recognition. Due to a wide range of actions, safety of use in children and lactating women, "Amoxicillin clavulanate" almost completely covers the sphere of empirical therapy of outpatient respiratory and genito-urinary infections.

Features of the issue and analogues

The drug "Amoxiclav 625" is produced by the Slovenian company Lek and is positioned as a medicine, the active substance of which is aminopenicillin amoxicillin and clavulanic acid. The first plays the role of an antibiotic, and the acid protects against bacterial beta-lactamases. In the composition "Amoxiclav 625 mg" tablets contain 500 mg of antibiotic, 125 mg of clavulanate and auxiliary substances.

The drug with the active substance amoxicillin is available under a variety of names. The most qualitative analogues are the following protected aminopenicillins: Amoclav, Augmentin, Flemoclav, Amklav, Farmentin, Amoxicar Plus, Augmenta, Medoklav. There are also unprotected penicillins, which are class analogues of "Amoxiclav": "Amoxicillin", "Amoxicar", "Amosin", "Hikontsil" and others. Their effectiveness is approximately the same.

Relevance of the drug

About the preparation "Amoxiclav 625" reviews of experts are very straightforward. This is a high-quality medicinal product, one of the few oral antimicrobial drugs that have few side effects. For this reason, it is used in all cases in which amoxicillin was appropriate. And "Amoxiclav" is a representative of combined preparations. It is protected by clavulanic acid from penicillinase, an enzyme that destroys the lactam ring of an antibiotic. Thanks to protection, "Amoxiclav" has become more active in relation to microbial cells.

Indications

Attached to the drug "Amoxiclav 625" instruction contains indications of infectious diseases, in the treatment of which the antibiotic is allowed to use. These are often developing respiratory, intestinal, urogenital infections of mild or moderate severity. In mild forms, monotherapy with the drug is appropriate, whereas the moderate and severe should be treated in a hospital with a combination of antibiotics. In general, the indications for the use of the drug "Amoxiclav 625 mg" the instruction describes as follows:

• Infection of the upper organs of the respiratory system (chronic and acute forms of tonsillitis, pharyngitis, sinusitis, otitis media);
• Infectious diseases of the lower respiratory tract (acute and chronic forms of bronchitis, pneumonia);
• Bacterial diseases of the genitourinary system (pyelonephritis, urethritis, cystitis, salpingoophoritis, pelvioperitonitis, endometritis, gonorrhea and chancroid);
• Chronic osteomyelitis;
• Skin infections, infected animal bites, bacteria-contaminated wounds;
• Periodontitis.

For the patient, the main information source about the drug "Amoxiclav" - instruction for use. 625 mg of medicinal substance, prescribed three times for an adult, can effectively treat diseases of the respiratory system, caused mainly by gram-positive flora. And with ARI treatment period is usually 5-7 days.

Contraindications

The safety of the drug and the record low toxicity of the class of penicillins does not exclude the presence of contraindications.

They have a little medicine. They are related either to the presence of a concomitant disease, to an allergic reaction or to the physiological state of the organism. Contraindications are as follows:

• The presence of indications for the occurrence of cholestatic jaundice, an increase in the activity of aminotransferases or the development of hepatitis caused by the earlier use of Amoxiclave, its analogues or representatives of the penicillin group;
• Hepatic failure, lymphocytic leukemia, mononucleosis due to aggravation of the number and severity of side effects;
• Allergic sensitization to the drug or its components;
• Indication of the appearance of allergic reactions of immediate type when taking other beta-lactam antimicrobial agents;
• Relative temporal contraindications: pregnancy in the 3rd trimester, lactation.

Risk of allergy development

If there is an indication in the patient's history of an allergy of a local type, then "Amoxiclav" is not assigned. If anaphylaxis or Quincke's edema develops in response to taking other beta-lactam antimicrobials, then "Amoxicillin clavulanate" should also not be taken. Then the drug of choice is a representative of a number of macrolides with a mild course or fluoroquinolone.

Dosing Modes

The amount of "Amoxiclav 625 mg" that is required for treatment depends on the age and weight of the patient. With diseases of the respiratory organs, it is rational to prescribe up to 2 grams for adults and 1.3 grams for adolescents. At the same time, "Amoxiclav" in a dose of 625 mg is only a teen and adult drug. For children younger than 12 years, there are drugs with smaller doses.

The standard dosage for a person weighing more than 40 kg and age more than 12 years is 625 mg twice a day. Adults under the age of 18 years are prescribed 625 mg three times a day. This is sufficient for the treatment of moderate and light, that is, ambulatory infections of the skin, respiratory system, urogenital system. In severe infections, 1000 mg (875 mg of amoxicillin and 125 clavulanates) are administered twice a day. A three-fold application of 1000 mg is allowed.

Side effect

Despite the sufficient breadth of the therapeutic effect, there are a number of side effects. They are associated with local impairments of bowel and stomach functions, as well as due to intoxication of the body with the products of bacterial cell decay, since the antibiotic acts bactericidally.

The most frequent (1-10%) are cases of nausea, vomiting, or diarrhea that occur after the use of an antimicrobial agent. And they appear after 2-4 days of admission. Significantly increases the likelihood of dyspepsia is an existing disruption in the bowel and some associated diseases: pancreatitis with excretory insufficiency, enteritis, a condition after resection of the stomach or intestine, chronic colitis.

The group of infrequent complications (0.001-0.0001%) include hepatic disorders: increased activity of aminotransferases and cytolysis markers of hepatocytes, cholestasis and jaundice, and leukopenia. In this case, the frequency of edema of Quincke, anaphylaxis and urticaria remains unspecified. The reason for this is a gradual increase in the number of allergic reactions due to early sensitization of children.

Later, this necessarily leads to a decrease in the therapeutic importance of the drug "Amoxiclav". Instruction for the use of 625-mg tablet does not prohibit the use of nursing mothers. However, this may happen soon. Then it will be necessary to look for a new drug from the group of aminopenicillins with similar efficacy. It is natural that a new chemical substance has already been synthesized and is being tested, but its introduction is not economically viable, because "Amoxiclav" meets the requirements of clinicians.

Reception at pregnancy and a lactemia

According to the FDA, "Amoxiclav" has no teratogenic effect. This conclusion is made after research on animals, because all the analogues of this drug belong to the B category by the FDA (USA). However, due to rational fears of aggravation of toxicoses, "Amoxiclav 625" during pregnancy is almost not appointed in the first trimester. In the II and III trimesters, his administration is permitted.

Aminopenicillins in trace amounts penetrate into the breast milk, which enter the gastrointestinal tract of the newborn. However, he does not cause any important violations in his body, because of which "Amoxiclav 625" can not be abolished during lactation. Exceptions are only cases of allergic reactions of the child or candidiasis of the mucous membranes or gastrointestinal tract, which occur when using "Amoxicillin." Then either the abolition of the antimicrobial agent by the mother is required, or - in case of mucosal candidiasis - refusal to breastfeed.

Characteristics of drug safety

The "Amoxiclav 625" tablets differ in a fairly wide range of therapeutic effects, which helps to avoid poisoning. Also, it does not have central effects, which can be taken by patients driving vehicles or other moving mechanisms. It does not lead to disturbances in memory, consciousness, attention, or thinking.

However, there is a drug overdose syndrome. Such cases are extremely rare and are manifested in cases of unreasonable single intake of 5 or more grams of the drug. Symptoms are the following symptoms: dyspeptic disorders associated with weight in the abdomen, bloating, diarrhea, nausea, sometimes vomiting.

There are cases of crystalluria, coupled with the use of amoxicillin, sometimes leading to the development of renal failure. However, this phenomenon can occur when taking the drug in therapeutic dosage. The treatment is nephroprotection and dialysis, which removes amoxicillin and clavulanic acid from the blood.

Precautionary measures

For patients with lymphatic leukemia or infectious mononucleosis, the preparation "Amoxiclav 625", analogues and its generics are not shown because of the high likelihood of development of a measles-like rash. And because of the decrease in the effectiveness of oral contraceptives on the background of Amoxicillin therapy, it is necessary to supplement the protection from unwanted pregnancy with barrier methods (condom).

With the development of diarrhea during the application of "Amoxiclave" it is necessary to cancel the antibiotic and treat colitis (hemorrhagic or pseudomembranous). In this situation, the use of "Loperamide" is unacceptable. Also, the long-term use of Amoxiclav promotes the development of many colonies of microorganisms that are not susceptible to an antimicrobial drug. They can cause complications of the current disease.

Known drug interactions

The uricosostatic drug "Allopurinol" when taken together with "Amoxiclav" increases the risk of skin rashes. The use of uricosuric "Probenecid", "Oxyphenbutazone", "Phenylbutazone", "Sulfinpyrazona" or acetylsalicylic acid reduces the release of aminopenicillin (but not clavulanic acid), which slightly increases the concentration of antibiotic in the serum and prolongs its effects.

Combinations of the preparation "Amoxiclav 625 mg" with bacteriostatic antimicrobial agents are irrational due to mutual suppression of their effectiveness. Other drugs containing amoxicillin should also not be combined with bacteriostatics: chloramphenicols, macrolides, tetracyclines and sulfonamides. Combination with bactericidal antibiotics leads to a mutual increase in antimicrobial activity.

Use of "Amoxiclav" during oral contraceptive therapy is irrational due to the risk of increased prothrombin time and the development of thrombosis. In this case, the effectiveness of the contraceptive is significantly reduced. Other broad-spectrum antibiotics also mediate the effect of reducing oral contraceptive effectiveness.

The use of "Amoxiclave" for the treatment of opportunistic infections that have arisen against methotrexate therapy significantly increases the toxicity of the latter. This increases the likelihood of developing thrombocytopenia, leukopenia, skin ulcers, gastrointestinal ulcers and erosion. Then it is recommended to abandon aminopenicillins and apply macrolides, continuing further treatment with methotrexate.

Like any wide-spectrum antibiotic, Amoxiclav increases the effectiveness of indirect anticoagulants. Therapy "Warfarin" because of the antimicrobial antagonism of the vital activity of bacteria synthesizing vitamin K leads to a decrease in the prothrombin index and an increase in INR. The result is a high risk of bleeding.

Aspects of combined antimicrobial therapy

The drug "Amoxiclav 625", analogs and its generics have the property of increasing the likelihood of developing diarrhea, if it is used with other antimicrobial agents. Any classes of antibiotics, along with amoxicillin, are more likely to cause diarrhea, which can not be treated with agents that depress peristalsis. This drug is "Loperamide" and its counterparts contraindicated in infectious diarrhea. In this case, diarrhea caused by the use of "Amoxiclav", should be treated with antibiotics.