active ingredients: amoxicillin, clavulanic acid;
5 ml of suspension contain amoxicillin (in the form of amoxicillin trihydrate) 200 mg and clavulanic acid (in the form of potassium clavulanate) 28.5 mg;
excipients: xanthan gum, aspartame (E 951), succinic acid, colloidal anhydrous silicon dioxide, hydroxypropyl methylcellulose, dry orange flavors (1 and 2), dry raspberry flavor, dry flavor “Light molasses”, silicon dioxide.
Powder for oral suspension.
Antibacterial agents for systemic use. ATC code J01C R02.
Treatment in adults and children bacterial infections caused by microorganisms sensitive to Augmentin, such as:
When prescribing antibacterial drugs, one should be guided by the rules for their proper use.
Hypersensitivity to any components of the drug, to any antibacterial agents of the penicillin group.
Presence in anamnesis severe reactions hypersensitivity (including anaphylaxis) associated with the use of other beta-lactam agents (including cephalosporins, carbapenems or monobactams).
History of jaundice or liver dysfunction associated with amoxicillin/clavulanate use.
The drug should be used in accordance with official recommendations for antibiotic therapy and local antibiotic sensitivity data, if available. Sensitivity to amoxicillin/clavulanate varies between regions and may change over time. If necessary, the sensitivity of the microorganism to the antibiotic should be determined.
The dose of the drug is prescribed by the doctor depending on the expected microorganisms and their sensitivity to antibacterial drugs, the severity of the disease and the location of the infection, the age, body weight and kidney function of the patient.
The duration of treatment is determined by the patient's clinical response to treatment. Some infections (such as osteomyelitis) require long-term treatment.
Adults and children weighing ≥ 40 kg
respiratory tract and urinary tract infections): 875 mg/125 mg (22.5 ml of prepared solution) 3 times a day.
For adults and children weighing ≥ 40 kg, the drug is prescribed in daily dose 1750 mg amoxicillin/250 mg clavulanic acid divided into 2 divided doses and 2625 mg amoxicillin/375 mg clavulanic acid divided into 3 divided doses.
Overweight children< 40 кг
For overweight children< 40 кг препарат назначают в суточной дозе 1000-2800 мг амоксициллина/143-400 мг клавулановой кислоты при применении как указано ниже.
Approximate calculation of Augmentin suspension (ml) per day (after amoxicillin)
|
Child's body weight, kg |
Dose 25 mg/kg/day |
Dose 45 mg/kg/day |
For the treatment of some infections, such as otitis media and sinusitis, lower respiratory tract infections, children over 2 years of age can use daily doses of up to 70/10 mg/kg body weight, divided into 2 doses.
If large doses of amoxicillin need to be prescribed for treatment, other forms of Augmentin should be used to avoid prescribing unnecessary high doses of clavulanic acid.
Renal dysfunction.
For children with speed glomerular filtration(SHKF) more than 30 ml/min, the dose does not need to be changed. For the treatment of children with a GFR less than 30 ml/min, Augmentin 228.5 mg/5 ml suspension is not recommended.
Liver dysfunction. Use with caution and regularly monitor liver function. The available data are insufficient to make dosage recommendations.
For optimal absorption and reduction of possible side effects from the gastrointestinal tract, the drug should be taken at the beginning of a meal.
Treatment should not be continued for more than 14 days without consulting a doctor.
You can start treatment with parenteral administration of the drug, and continue with the oral form of the drug.
Instructions for preparing the suspension.
1. Check the bottle cap relative to its previous opening.
2. Turn over and shake the bottle to loosen the powder in it.
3. Pour boiled water into the bottle with powder to the lower level indicated by the red line with an arrow.
4. Close the cap and shake the bottle until a suspension is formed.
5. Then add the rest of the water to the top level indicated by the black line with an arrow and shake again.
6. The suspension should be allowed to stand for 5 minutes until the powder is completely dispersed.
7. Shake the suspension thoroughly before each dose.
To accurately measure the dose of the drug, use a measuring cap, which should be rinsed with water after each use.
Side effects were classified according to their frequency of occurrence.
The following classification of the frequency of side effects is used:
very often 3 1/10;
often 3 1/100 and< 1/10;
infrequently 3 1/1000 and< 1/100;
rarely 3 1/10000 and< 1/1000;
very rarely< 1/10000.
Infections and infestations.
Common: candidiasis of the skin and mucous membranes.
Circulatory and lymphatic systems.
Rare: reversible leukopenia (including neutropenia) and thrombocytopenia.
Very rare: reversible agranulocytosis and hemolytic anemia, increased bleeding time and prothrombin index.
Immune system.
Very rarely: angioedema, anaphylaxis, serum sickness-like syndrome, allergic vasculitis.
Nervous system.
Uncommon: dizziness, headache.
Very rare: reversible hyperactivity and seizures. Seizures may occur in patients with impaired kidney function or in those receiving high doses of the drug.
Gastrointestinal tract.
Adults
Very common: diarrhea.
Common: nausea, vomiting.
Children
Common: diarrhea, nausea, vomiting.
Nausea is more often associated with high doses of the drug. The above symptoms from gastrointestinal tract can be reduced if the drug is taken at the beginning of a meal.
Uncommon: indigestion.
Very rare: antibiotic-associated colitis (including pseudomembranous colitis and hemorrhagic colitis), black “hairy” tongue. Very rarely, children experience superficial discoloration of teeth. Proper oral care can prevent this phenomenon. Discoloration can be corrected by brushing your teeth.
Hepatobiliary reactions.
Uncommon: Moderate increases in AST and/or ALT levels have been observed in patients treated with beta-lactam antibiotics, although clinical significance this has not been established.
Very rare: hepatitis and cholestatic jaundice. These phenomena occur with the use of other penicillins and cephalosporins.
Hepatitis occurred mainly in men and elderly patients; their occurrence may be associated with prolonged treatment with the drug.
In children, such phenomena occurred very rarely.
Symptoms of the disease occur during or immediately after treatment, but in some cases they may occur several weeks after the end of treatment. These phenomena are usually reversible. Liver dysfunction can be severe and very rarely fatal. This almost always occurs in patients with severe underlying disease or in patients who are simultaneously being treated with drugs that have a negative effect on the liver.
Skin and subcutaneous tissues.
Uncommon: skin rashes, itching, urticaria.
Rarely: erythema multiforme.
Very rare: Stevens-Johnson syndrome, toxic epidermal necrolysis, blistering exfoliative dermatitis, acute generalized exanthematous pustulosis.
In the event of any allergic dermatitis treatment should be stopped.
Kidneys and urinary system.
Very rarely: interstitial nephritis, crystalluria (see section “Overdose”).
An overdose may be accompanied by gastrointestinal symptoms and water and electrolyte balance disorders. These phenomena are treated symptomatically, paying attention to the correction of water and electrolyte balance. Cases of crystalluria have been reported, which sometimes led to renal failure (see section "Peculiarities of application"). Augmentin can be removed from the bloodstream by hemodialysis.
Use during pregnancy or breastfeeding
Pregnancy. Reproductive studies in animals (mice and rats) of oral and parenteral forms of Augmentin did not reveal any teratogenic effects. One study in women with premature rupture of membranes reported that prophylactic use of Augmentin may be associated with an increased risk of necrotizing enterocolitis in newborns. As with other medications, use of the drug should be avoided during pregnancy, especially in the first trimester, unless in the opinion of a physician, such use is necessary.
Breastfeeding period. Both active components of the drug are excreted into breast milk (there is no information regarding the effect of clavulanic acid on an infant who is on breastfeeding). Accordingly, a breastfed baby may develop diarrhea and fungal infections of the mucous membranes, so breastfeeding should be stopped.
Augmentin can be used during breastfeeding only when, in the opinion of the doctor, the benefits of use will outweigh the risks.
Children
Used for children aged 2 months and older.
Before starting Augmentin therapy, it is necessary to accurately determine whether there is a history of hypersensitivity reactions to penicillins, cephalosporins or other allergens.
Serious and sometimes fatal cases of hypersensitivity (anaphylactoid reactions) have been observed in patients during penicillin therapy. Such reactions more often occur in patients with a history of hypersensitivity to penicillins (see section “Contraindications”).
If it is proven that the infection is caused by microorganisms sensitive to amoxicillin, it is necessary to weigh the possibility of switching from the amoxicillin/clavulanic acid combination to amoxicillin according to official recommendations.
Augmentin should not be prescribed if there is suspicion of infectious mononucleosis, since when amoxicillin was used for this pathology, cases of root-like rash were observed.
Long-term use of the drug may cause excessive growth of microflora insensitive to Augmentin.
The development of erythema multiforme associated with pustules at the beginning of treatment may be a symptom of acute generalized exanthematous pustulosis. In this case, it is necessary to stop treatment and further administration of amoxicillin is contraindicated.
Rarely, patients taking Augmentin and oral anticoagulants may experience an increase in prothrombin time beyond normal (increased international normalized ratio (INR). When taking anticoagulants concomitantly, appropriate monitoring is required. Dosage adjustment of oral anticoagulants may be necessary to maintain the required level of anticoagulation.
Augmentin should be prescribed with caution to patients with liver dysfunction. Changes reported functional tests liver in some patients who were treated with Augmentin.
There are isolated reports of cholestatic jaundice, which may have severe course, but is usually reversible. Symptoms may not appear until 6 weeks after finishing treatment.
For patients with impaired renal function, Augmentin 228.5 mg/5 ml suspension is not recommended (see section “Dosage and Administration”).
In patients with reduced urine excretion, crystalluria may very rarely occur, mainly with parenteral administration of the drug. Therefore, to reduce the risk of crystalluria, it is recommended that during treatment with high doses of amoxicillin, maintain an adequate balance between the fluid consumed and urine excreted (see section “Overdose”).
When treating with amoxicillin, enzymatic reactions with glucose oxidase should be used to determine the level of glucose in urine, since other methods may give false positive results.
The presence of clavulanic acid in the drug can cause nonspecific binding of IgG and albumin on erythrocyte membranes, therefore, as a result, a false positive result is possible when performing the Coombs test.
There are reports of false positive test results for Aspergillus in patients treated with amoxicillin/clavulanic acid (using Bio-Rad Laboratories Platelis Aspergillus EIA test). Therefore, such positive results in patients treated with amoxicillin/clavulanic acid should be interpreted with caution and confirmed by other diagnostic methods.
Augmentin suspension 228.5 mg/5 ml contains aspartame 12.5 mg/5 ml - a source of phenylalanine, so the drug should be administered with caution to patients with phenylketonuria.
The ability to influence reaction speed when driving vehicles or operating other mechanisms
No negative effects on the ability to drive a car or use other machinery were observed, but the possibility of such a side effect as dizziness should be taken into account.
Concomitant use of probenecid is not recommended. Probenecid reduces renal tubular secretion of amoxicillin. Its simultaneous use with Augmentin can lead to an increase in the level of amoxicillin in the blood for a long time, but does not affect the level of clavulanic acid.
Penicillins may reduce the excretion of methotrexate, which may increase the toxicity of the latter.
Concomitant use of allopurinol during treatment with amoxicillin may increase the likelihood of allergic skin reactions. There are no data regarding the simultaneous use of Augmentin and allopurinol.
Like other antibiotics, Augmentin can affect the intestinal flora, which will lead to a decrease in the reabsorption of estrogens and a decrease in the effectiveness of combined oral contraceptives.
According to the literature, there are isolated reports of increased INR levels in patients treated with acenocoumarol or warfarin and taking amoxicillin. If such use is necessary, the prothrombin time or INR level should be carefully monitored with the addition or discontinuation of Augmentin treatment.
Pharmacodynamics.
Amoxicillin - semisynthetic antibiotic with a broad spectrum of antibacterial activity against many gram-positive and gram-negative microorganisms. Antibiotic resistance is caused by the release of bacterial enzymes that destroy the antibiotic before it can act on the bacterium. Clavulanic acid in Augmentini blocks β-lactamase enzymes and restores the sensitivity of microorganisms to the bactericidal effect of amoxicillin. Clavulanate has a slight antibacterial activity, but its combination with amoxicillin in Augmentini is an antibacterial drug with a wide range of applications in outpatient and hospital practice.
Microorganisms listed below, categorized according to sensitivity to amoxicillin/clavulanate in vitro.
Sensitive microorganisms
Gram-positive aerobes: Bacillus anthracis, Enterococcus faecalis, Listeria monocytogenes, Nocardia asteroids, Streptococcus pyogenes, Streptococcus agalactiae, other β-hemolytic species Streptococcus, Staphylococcus aureus(methicillin-sensitive strains), Staphylococcus saprophyticus(methicillin-sensitive strains) , coagulase-negative staphylococci (methicillin-sensitive strains).
Gram-negative aerobes: Bordetella pertussis, Haemophilus influenza, Haemophilus parainfluenzae, Helicobacter pylori, Moraxella catarrhalis, Neisseria gonorrhoeae, Pasteurella multocida, Vibrio cholera.
Other: Borrelia burgdorferi, Leptospirosa ictterohaemorrhagiae, Treponema pallidum.
Gram-positive anaerobes: types Clostridium, Peptococcus niger, Peptostreptococcus magnus, Peptostreptococcus micros, species Peptostreptococcus.
Gram-negative anaerobes: types Bacteroides ( including Bacteroides fragilis), species Capnocytophaga, Eikenella corrodens, species Fusobacterium, Fusobacterium nucleatum, species Porphyromonas, species Prevotella.
Strains with possible acquired resistance
Gram-negative aerobes: Escherichia coli, Klebsiella oxytoca, Klesiella pneumonia, species Klebsiella, Proteus mirabilis, Proteus vulgaris, species Proteus, species Salmonella, species Shigella.
Gram-positive aerobes: types Corynebacterium, Enterococcus faecium, Streptococcus pneumonia, Streptococcus groups viridans.
Insensitive microorganisms
Gram-negative aerobes: types Acinetobacter, Citrobacter freundii, species Enterobacter, Hafnia alvei, Legionella pneumophila, Morganella morganii, species Providencia species Pseudomonas, species Serratia, Stenotrophomas maltophilia, Yesinia enterolitica.
Other: Chlamydia pneumonia, Chlamydia psittaci, species Chlamydia, Coxiella burnetti, species Mycoplasma.
Pharmacokinetics.
Absorption. Both components of Augmentin (amoxicillin and clavulanic acid) are completely soluble in aqueous solutions at physiological values pH. Both components are quickly and well absorbed when taken orally. Augmentin absorption improves when taken at the beginning of a meal.
The serum concentrations of amoxicillin achieved with Augmentin are similar to those achieved with oral administration of equivalent doses of amoxicillin itself.
Concomitant use of probenecid inhibits the excretion of amoxicillin, but does not affect the renal excretion of clavulanic acid.
Distribution. When administered internally, therapeutic concentrations of amoxicillin and clavulanic acid are observed in tissues and interstitial fluid. Therapeutic concentrations of both substances were found in the gallbladder, tissues abdominal cavity, skin, fat and muscle tissue, as well as in synovial and peritoneal fluids, bile and pus. Amoxicillin and clavulanic acid are weakly protein bound; Studies have found that protein binding rates are 25% for clavulanic acid and 18% for amoxicillin of their total plasma concentrations. Animal studies have not shown accumulation of any of these components in any organ.
Amoxicillin, like other penicillins, can be found in breast milk. Trace amounts of clavulanic acid can also be found in breast milk. Research reproductive function Animal studies have shown that both amoxicillin and clavulanic acid can cross the placental barrier. However, there was no evidence of impaired fertility or harmful influence for the fruit.
Conclusion. The main route of elimination of amoxicillin, like other penicillins, is renal excretion, while clavulanate is eliminated by both the kidneys and extrarenal mechanisms. Approximately 60-70% of amoxicillin and 40-65% of clavulanic acid are excreted unchanged in the urine during the first 6 hours.
Basic physical and chemical properties
white or whitish effervescent powder with a characteristic odor.
Store original packaging closed at temperatures below 25 °C in a dry place.
Store the prepared suspension in the refrigerator at a temperature of 2 to 8 °C for 7 days. Keep out of the reach of children.
Powder for oral suspension 70 ml (200 mg/28.5 mg/5 ml) in bottles with a measuring cap in a cardboard package.
SmithKline Beecham Pharmaceuticals, UK.
SmithKline Beecham Pharmaceuticals, Clarendon Road, Worthing, West Sussex,
Smithkline Beecham Pharmaceuticals, Clarendon Road, Worthing, West Sussex,
BN14 8QH, UK.
During their growth and maturation, children often have to deal with various diseases. For each of them, parents should go to a specialist to receive a competent prescription. However, few people do this. In this case, children receive the wrong therapy, and complications begin. Most of these consequences have to be eliminated with antibiotics. Such medications are also taken for bacterial infections. This article will tell you how to properly use the Augmentin medication for a child. There are different reviews about this medicine. You will also learn about them further.
The dosage of Augmentin may vary. This is indicated in the instructions for use. The drug is available in the form of tablets, a suspension for internal use and a powder, which, after dilution, is administered intravenously. So, the dose of the drug in each separate form can be 125, 200, 375, 400, 500, 600, 875 and 1000 mg of active ingredient.
The main components of this drug are amoxicillin and, depending on the type of drug, it also contains additional components. For example, syrup contains flavoring. The tablets contain talc and magnesium stearate.
The price of Augmentin varies depending on what form and dosage of the medication you purchase. Remember that the doctor should select the dose of the medicinal substance. After this, you can go to the pharmacy chain and purchase the appropriate medication.
Tablets in a dose of 375 milligrams will cost you about 300 rubles. When buying capsules of 1000 milligrams, you will have to pay almost 500 rubles for the medicine. The price for Augmentin syrup is slightly higher than for the same dose of tablets. Thus, one package of this form of the drug costs almost 400 rubles.
The described medicine is prescribed to children by a pediatrician. In this case, it is recommended to first pass a sensitivity test to microorganisms. During such a study, resistance is determined pathogenic flora to the described substance. After this analysis, the doctor can confidently prescribe the appropriate medicine.
Indications for use of the drug in a child should be as follows:
Not in every case it is possible to use the drug "Augmentin" for a child. Reviews from experts indicate that some children are allergic to. In this case, the use of the described drug is strictly contraindicated. Also do not use the product if there is hypersensitivity to any of its components.
It is contraindicated to use the drug "Augmentin" for jaundice or acute liver failure. If previously such a reaction was observed immediately after using amoxicillin and clavulanic acid, then prescribing the drug is unacceptable.
The dosage of Augmentin significantly affects the possibility of its use. The tablets are never used in children under 12 years of age. For this form of medication, the patient must have a body weight of more than 40 kilograms. The drug in the form of a suspension is not prescribed to children under 3 months.
The use of the drug is contraindicated in case of acute renal failure or dysfunction of this organ. The medication is not prescribed to persons with phenylketonuria. Please note that the syrup for internal use contains sugars.
How to properly use the medicine "Augmentin" for sore throat and other types of pathology? The dose of the drug depends on the age and body weight of the patient. Experts also pay attention to the severity of the disease.
The daily dose of the drug for children over 12 years of age is 750 mg. You need to divide this amount into three doses. If the disease is severe, the dosage can be increased to 1750 milligrams of the active substance.
For babies from three months of age, the drug is prescribed depending on body weight. For mild pathology, 20 milligrams of the drug per kilogram of weight is used. If the infection is severe, then 40 milligrams are prescribed. In this case, the indicated portion is taken three times a day. Twice daily use is acceptable, but in this case the amount of medication increases to 45 milligrams per kilogram.
Specialists usually prescribe a strictly defined amount of medication. They may recommend that your baby take, for example, 5, 6 or 7 milliliters of the suspension. However, you should always double-check this assignment. Remember that there are often overdoses of the drug, which lead to unpleasant consequences.
How to calculate the portion that is ideal for your child is described in the instructions. For example, your baby weighs 10 kilograms at 8 months. How much medicine does he need? For mild cases of the disease, 20 milligrams of amoxicillin per kilogram is prescribed. This is 200 milligrams of active ingredient for your child. Please note that the suspension also has different dosages. If you have Augmentin 400 syrup (5 ml), then your baby is prescribed 2.5 milliliters of this medicine.
In severe cases of the disease, 40 milligrams are prescribed for every kilogram of the child’s weight. This would correspond to 400 milligrams of amoxicillin. In this case, the baby is supposed to take 5 milliliters of the drug at a time.
The drug "Augmentin" for sore throat and other diseases is taken for at least five days. This condition is mandatory. Even if your baby feels better and you don’t want to give him an extra dose of medicine, you will have to take the medicine for a strictly specified time. If the described drug is discontinued prematurely, there is a high probability of developing resistance of microorganisms to it. However, next time the specified medication simply will not help the child. The maximum duration of therapy is two weeks.
The drug can be used regardless of food intake. However, to reduce adverse reactions, it is recommended to use the composition at the very beginning of the meal. For children under two years of age, the medicine can be diluted with water in a one to one ratio. This means that if you take 5 milliliters of medication, you can add it to one teaspoon of water. Therapy for newborn children is carried out strictly within the walls of a hospital under the supervision of doctors and daily monitoring of blood conditions.
The drug "Augmentin 200" for children may cause some adverse reactions, like other dosages of this medication. One of these is allergies. It usually manifests itself as a rash, itching of the skin and common urticaria. Less commonly, a more serious complication may occur - bronchospasm and edema.
From the outside digestive system Augmentin (syrup or tablets) may cause nausea, vomiting, changes in taste in the mouth, and other symptoms. To ease their manifestation as much as possible, take the drug during meals.
Augmentin (syrup) should always be taken with water. The drug should not be kept in the mouth. This can lead to the development of a fungal infection on the mucous membrane. Rarely, blood diseases occur during treatment. However, if they are present, the pathology may worsen.
Often during treatment, patients complain of abdominal pain, indigestion, diarrhea and increased gas formation. With the development of any adverse reaction you need to report it to your doctor. If possible, the specialist will adjust the treatment. It is less common to completely discontinue the drug. There are reported cases deaths associated with the use of the described product. Usually these are the people who have had serious illnesses liver. At the same time, this medication aggravated clinical picture and led to organ failure.
Often, Augmentin 400 and other forms of the drug are prescribed simultaneously with other medications. However, you should always discuss your regimen with your doctor. It is permissible to use complexes simultaneously beneficial bacteria. These medications will help reduce the number and severity of adverse reactions.
Often the medication is combined with sorbents. These medications should be taken at least two hours apart. Otherwise, the effectiveness of the antibiotic will be greatly reduced.
Doctors' reviews about the drug "Augmentin" for a child say that the medication should be taken strictly according to the instructions. In this case, it will be effective and safe. The medicine is not discontinued if mild side effects develop. However, in severe cases negative reaction therapy should be discontinued.
If during treatment a child develops an allergy, then specialists must enter this data into the card. Subsequently, this baby should not be prescribed penicillin antibacterial drugs.
Augmentin – unique remedy, which includes potent ingredients: amoxicillin 250, 500, 875 mg and clavulanic acid 125 mg (similar in composition to penicillin). The active ingredient amoxicillin is easily tolerated by the body, side effects are rare, so the drug is safe for small children. Augmentin is allowed to be used by women during pregnancy (as prescribed by the attending physician) and infants.
For marking medicine It is customary to use the abbreviated names Augmentin 400, 600 with the obligatory clarification of the dosage.
The antibiotic Augmentin is produced in several forms:
During the course of treatment, it is possible to change medicinal type product (instead of injections, they are prescribed to take pills). All forms of Augmentin are intended for the treatment of bacterial infections that provoke the following diseases in children:
Augmentin is considered an excellent treatment for bacterial infection palatine tonsils, i.e. tonsillitis. When treating angina, the drug is taken in a dosage of 875 mg once a day or 500 mg 3 times a day. The duration of treatment for sore throat is 7-8 days. Also, for a sore throat, the doctor may prescribe an analogue of the drug.
Instructions for use recommend taking the drug or an analogue before meals to reduce the risk of the disorder digestive tract. Duration of therapy is no more than 2 weeks, but not less than 5 days. Augmentin dosage is set individually, based on age category patient, weight and complexity of the disease. The use of the medicine was divided into age categories in order to conveniently calculate the dose for children.
Adults and children over 12 years of age (weight category not exceeding 40 kg):
In case of severe infection, the use of the antibiotic Augmentin or its analogues is prescribed according to the dosage:
In adults and children undergoing hemodialysis, use the drug (analogue) according to the instructions:
In the first 3 months and less than 12 years (weight category up to 45 kg), a suspension (syrup) is prescribed for children as a convenient use; the child’s weight is taken into account when calculating the correct dosage:
Small doses of the drug are used to treat skin infections, and larger doses are prescribed to treat infections of the upper and lower respiratory tract.
Infants and children up to 3 months inclusive are recommended to take a dosage of 30 mg/kg 2 times a day. If a suspension is chosen for the course of treatment, it must be diluted in a ratio of 4:1. The use of Augmentin suspension is calculated in a ratio of 7:1 (200 mg/28.5 mg in 5 ml or 400, 600 mg/57 mg in 5 ml).
The use of Augmentin by patients with liver dysfunction is carried out under the strict supervision of the attending physician, with mandatory monitoring of changes in well-being. Unfortunately, there are no clear dosage calculation data for this category of patients.
According to the instructions, the drug is stored in a dry place, out of reach of children, at an average temperature of no more than 25 degrees. Shelf life: 2 years (see manufacturing date on packaging).
To prepare a suspension at a dosage of 125 mg/31.25 mg in 5 ml, dissolve the powder in boiled water, cooled to room temperature, close the bottle and shake well. The powder should completely dissolve. Leave the bottle for a few minutes, add water to the indicated mark and shake again. Each time you use the suspension, the bottle must be shaken. Store the drug in a cool place for no more than 7 days from the date of preparation.
If the suspension is to be used by a child under 2 years of age, you can dilute the drug using twice as much water.
The dosage (200, 250 mg/28.5 mg in 5 ml or 400, 600 mg/57 mg in 5 ml) is prepared in the same way, the method of storing the finished suspension is identical. For a child under 2 years old, prepare a measured single dose in a 1:1 ratio. Store the prepared suspension in a cool place for 7 days after its preparation.
The instructions specify contraindications for the use of the drug:
The drug is not compatible with blood products containing protein; it is forbidden to mix the drug with a dropper with aminoglycoside antibiotics, because inactivation occurs.
If the child is prone to allergies, has had allergic reactions to antibiotics or has impaired liver function when taking similar drugs, taking Augmentin is not recommended. Children with allergies should be treated with antibacterial drugs very carefully so as not to provoke urticaria, Quincke's edema and other reactions. It is strictly forbidden to take the drug during pregnancy (first trimester).
Like anyone antibacterial drug, Augmentin can cause characteristic side effects:
Very rarely, the drug can cause anaphylactic shock, exfoliative dermatitis, angioedema. In rare cases, when the drug is administered intravenously, phlebitis may occur, i.e. inflammation of the vein at the injection site.
Thank you
Augmentin is a combined antibiotic broad spectrum of action, used to treat bacterial infectious diseases respiratory tract (bronchitis, pneumonia, bronchopneumonia), ENT organs (otitis, sinusitis, tonsillitis, pharyngitis), skin and subcutaneous tissue (abscess, phlegmon, cellulitis, wound), genitourinary system (cystitis, urethritis, pyelonephritis, salpingitis, vaginitis, gonorrhea, endometritis), as well as osteomyelitis, sepsis and peritonitis. In addition, Augmentin is used for the prevention and treatment of infections after surgery.
All three of these varieties of Augmentin are commercial versions of the same antibiotic with exactly the same effects, indications and rules of use. The only difference between commercial varieties of Augmentin is the dosage active substance and release form (tablets, suspension, powder for solution for injection). These differences allow you to choose the best option medicinal product for each specific case. For example, if for some reason an adult is unable to swallow Augmentin tablets, he can use Augmentin EC suspension, etc.
Usually, all varieties of the drug are simply called “Augmentin”, and to clarify what exactly is meant, they simply add the name of the dosage form and dosage, for example, Augmentin suspension 200, Augmentin tablets 875, etc.
Varieties of Augmentin are available in the following dosage forms:
1.
Augmentin:
The composition of all varieties and dosage forms of Augmentin as active ingredients includes the following two substances: However, it has one drawback - many bacteria develop resistance to amoxicillin after a few days of use, since the microbes begin to produce special substances - lactamases that destroy the antibiotic. This drawback limits the use of amoxicillin in the treatment of bacterial infections.
However, the deficiency of amoxicillin is eliminated clavulanic acid , which is the second component of Augmentin. Clavulanic acid is a substance that inactivates lactamases produced by bacteria and, accordingly, makes amoxicillin effective even against microbes that were previously insensitive to its action. That is, clavulanic acid makes amoxicillin effective against bacteria that were resistant to its action, which significantly expands the range of applications combination drug Augmentin.
Thus, the combination of amoxicillin + clavulanic acid makes the antibiotic more effective, expands its spectrum of action and prevents the development of bacterial resistance.
Each dosage form of Augmentin contains two active ingredients– amoxicillin and clavulanic acid, so the dosage of the drug is indicated not in one number, but in two, for example, 400 mg + 57 mg, etc. Moreover, the first number always indicates the amount of amoxicillin, and the second - clavulanic acid. Thus, Augmentin in the form of a powder for the preparation of a solution for injection is available in dosages of 500 mg + 100 mg and 1000 mg + 200 mg. This means that after diluting the powder with water, a solution is obtained that contains 500 mg or 1000 mg of amoxicillin and, respectively, 100 mg and 200 mg of clavulanic acid. Data in use dosage forms are usually simply designated “Augmentin 500” and “Augmentin 1000”, using a number reflecting the content of amoxicillin and omitting the amount of clavulanic acid.
Augmentin in the form of a powder for the preparation of a suspension for oral administration is available in three dosages: 125 mg + 31.25 mg per 5 ml; 200 mg + 28.5 mg per 5 ml and 400 mg + 57 mg per 5 ml. In everyday life, the designation of the amount of clavulanic acid is usually omitted, and only the content of amoxicillin is indicated, since the dosage is calculated based on the antibiotic. Thanks to this, the short designations for suspensions of various dosages look like this: “Augmentin 125”, “Augmentin 200” and “Augmentin 400”.
The dosage of Augmentin suspensions is per 5 ml: that is, 125 mg per 5 ml, 200 mg per 5 ml and 400 mg per 5 ml. The content of the active substance in terms of 5 ml means that after preparing the suspension from the powder, it is 5 ml (and not 1 ml) of the finished solution that will contain 125 mg, 200 mg or 400 mg of amoxicillin.
Since Augmentin suspension is used in children under 12 years of age, it is often called “children’s Augmentin”. Accordingly, the suspension dosages are also called children's dosages. In fact, the dosages of the suspension are standard and can also be used in adults with low body weight, but due to the predominant use of this form of the drug for children, they are called children's dosages.
Augmentin tablets are available in three dosages: 250 mg + 125 mg; 500 mg + 125 mg and 875 mg + 125 mg, differing only in the content of amoxicillin. Therefore, in everyday life, tablets are usually shortened, indicating only the dosage of amoxicillin: “Augmentin 250”, “Augmentin 500” and “Augmentin 875”. The indicated amount of amoxicillin is contained in one Augmentin tablet.
Augmentin EC is available in powder form for the preparation of a suspension in a single dosage - 600 mg + 42.9 mg per 5 ml. This means that 5 ml of the finished suspension contains 600 mg of amoxicillin and 42.9 mg of clavulanic acid.
Augmentin SR is available in the form of tablets with a single dosage of active substances – 1000 mg + 62.5 mg. This means that one tablet contains 1000 mg of amoxicillin and 62.5 mg of clavulanic acid.
Augmentin has one therapeutic effect– antibacterial, since it has a detrimental effect on wide range various pathogenic microbes that cause infectious and inflammatory diseases of the genitourinary and respiratory tracts, skin and subcutaneous tissue, as well as osteomyelitis, sepsis and peritonitis. That is, Augmentin destroys bacteria that provoke infections of these organs and, accordingly, cures infectious and inflammatory diseases. The presence of clavulanic acid in Augmentin makes the drug highly effective, since it allows it to expand the spectrum of action of amoxicillin and make it effective against bacteria that, when used in isolation, are resistant to this antibiotic.
Before taking the suspension, measure required quantity using a special measuring cap or graduated syringe. The suspension is taken orally by swallowing the measured required amount directly from the measuring cap. Children who for some reason cannot drink a pure suspension are recommended to dilute it with water in a 1:1 ratio, after pouring the required amount from a measuring cap into a glass or other container. The measuring cap or syringe should be washed after use. clean water.
In order to reduce discomfort and side effects from the gastrointestinal tract, it is recommended to take tablets and suspension at the beginning of meals. However, if for some reason this is not possible, then the tablets can be taken at any time in relation to food, since food does not have a significant effect on the effects of the drug.
Augmentin injections are made only intravenously. The solution can be administered by stream (from a syringe) or infusion ("dropper"). Not allowed intramuscular injection drug! The injection solution is prepared from the powder immediately before administration and is not stored even in the refrigerator.
Taking tablets and suspensions, as well as intravenous administration of Augmentin solution should be done at regular intervals. For example, if you need to take the drug twice a day, then you should maintain the same 12-hour interval between doses. If you need to take Augmentin 3 times a day, then you should do this every 8 hours, trying to strictly observe this interval, etc.
The minimum acceptable course of use of any form and variety of Augmentin is 5 days. This means that you cannot take the drug for less than 5 days. The maximum permissible duration of use of any form and variety of Augmentin without repeated examinations is 2 weeks. That is, after a diagnosis has been made, without repeated examination, you can take the drug for no longer than 2 weeks. If, during therapy, a repeated examination was carried out, which revealed a positive, but slow dynamics of cure, then based on these results, the duration of taking Augmentin can be increased to 3 or even 4 weeks.
If necessary, stepwise therapy can be carried out, consisting of: consistent application injections and tablets or suspensions orally. In this case, first to obtain maximum effect Augmentin is injected and then switched to tablets or suspension.
Should not be replaced various shapes and dosages of Augmentin on top of each other, for example, instead of one tablet 500 mg + 125 mg, take 2 tablets 250 mg + 125 mg, etc. Such substitutions cannot be made because different dosages even the same form of the drug is not equivalent. Since there is a wide choice of Augmentin dosages, you should always choose the one you need, and not use the one you have, trying to replace what you need.
Children under 12 years of age or weighing less than 40 kg should take Augmentin only in suspension form. In this case, babies under 3 months can only be given a suspension with a dosage of 125/31.25 mg. In children over 3 months of age, it is allowed to use suspensions with any dosage of active ingredients. It is precisely because Augmentin suspension is intended for children that it is often called simply “children’s Augmentin” without indicating the dosage form (suspension). The dosage of the suspension is calculated individually based on the age and body weight of the child.
Augmentin injections can be used for children of any age and for adults, after first calculating the individual dosage based on body weight.
Augmentin EC suspension and Augmentin SR tablets can only be taken by adults and children over 12 years of age or weighing more than 40 kg.
You cannot pour out all the powder from the bottle and divide it, for example, into 2, 3, 4 or more parts, and then dilute the resulting parts separately. Such crushing leads to inaccuracy of dosage and uneven distribution of active substances among parts of the powder, since it is impossible to mix it so that the molecules of the active components are perfectly evenly distributed throughout the entire volume. This, in turn, causes ineffectiveness of the suspension made from one half of the powder, and overdoses of the suspension made from the other part of the powder. That is, after crushing, there could be few active substances in one part of the powder, and, on the contrary, too much in another. As a result, a suspension made from a powder with a low content of active components will contain a much lower concentration of amoxicillin and clavulanic acid than necessary. And another suspension, prepared from powder with a large amount of amoxicillin and clavulanic acid, will contain, on the contrary, too much greater concentration active components.
A suspension with any dosage of active components is prepared as follows:
1.
Add 60 ml of boiled water to the bottle with powder. chilled water(the amount of water can be measured with a syringe).
2.
Screw on the cap of the bottle and shake it vigorously until the powder is completely dissolved.
3.
Then place the bottle on a flat surface for 5 minutes.
4.
If, after this, undissolved powder particles have collected at the bottom, you should shake the bottle vigorously again and place it again on a flat surface for 5 minutes.
5.
When, after 5 minutes of settling, there are no particles of powder left at the bottom of the bottle, open the lid and add boiled cooled water to the mark.
It must be remembered that to prepare a suspension with a dosage of 125/31.25 you will need more water (approximately 92 ml) than for dosages 200/28.5 and 400/57 (approximately 64 ml). Therefore, for the first dissolution you need to take no more than 60 ml of water (it is possible to pour a little less, but not more, so that after receiving the suspension it does not turn out that its level is higher than the mark on the bottle).
The finished suspension can be stored in the refrigerator (not frozen) for a week, after which any unused remainder should be discarded. If the course of treatment lasts more than 7 days, then after a week of storage you need to throw away the remains of the old solution and prepare a new one.
If Augmentin is administered as a stream, then the required amount of solution is drawn directly from the bottle into a sterile syringe and administered intravenously slowly over 3 to 4 minutes. For inkjet intravenous administration The solution should be prepared immediately before use. The maximum permissible storage time for the prepared solution before intravenous injection- no more than 20 minutes.
If Augmentin is administered as a dropper, then the contents of the bottle (the entire prepared solution) are poured into the infusion fluid already in the system (dropper). Moreover, a solution with an active substance content of 500/100 is diluted with 50 ml of infusion fluid, and a solution with a dosage of 1000/200 is diluted with 100 ml of infusion fluid. Then the entire volume of the resulting solution is administered dropwise over 30–40 minutes.
The following drugs can be used as infusion fluid:
Before use, you should select a powder with the right dosage and prepare a suspension. The prepared suspension should be stored in the refrigerator, without freezing, for a maximum of 7 days. If you need to take it for more than a week, then the remnants of the old suspension stored in the refrigerator should be thrown away on the 8th day and a new one should be prepared. Before each dose, it is necessary to shake the bottle of suspension, and only after that take the required amount using a measuring cap or an ordinary syringe with graduations. The cap and syringe should be rinsed with clean water after each use.
The suspension can be drunk directly from the measuring cap or first poured into a small container, such as a glass, etc. It is recommended to pour the suspension drawn into a syringe into a spoon or glass. If for some reason it is difficult for a child to swallow a pure suspension, then the measured amount for a single dose can be further diluted with water in a 1:1 ratio. However, you cannot immediately dilute the powder with twice as much water. The suspension should be diluted before each dose and only the amount needed for one dose.
Dosages of Augmentin in each specific case are calculated individually according to the child’s body weight, age and severity of the disease. In this case, only amoxicillin is taken for calculations, and clavulanic acid is neglected. It should be remembered that children under 2 years of age should be given only Augmentin 125/31.5 suspension. And children over two years old can be given a suspension with any dosage of active substances (Augmentin 125, 200 and 400).
Children under 3 months The daily dosage of Augmentin suspension should be calculated based on the ratio of 30 mg of amoxicillin per 1 kg. Then the amount of mg is converted to milliliters, the resulting daily dosage is divided by 2 and given to the child twice a day every 12 hours. Let's consider an example of calculating the dose of Augmentin 125/31.25 suspension for a child aged 1 month with a body weight of 6 kg. So, daily dosage for him is 30 mg * 6 kg = 180 mg. Next, you need to calculate how many milliliters of suspension 125/31.25 contain 180 mg of amoxicillin. To do this, we create a proportion:
125 mg in 5 ml (this is the concentration of the suspension declared by the manufacturer)
180 mg in X (x) ml.
From the proportion we create an equation: X = 180 * 5/125 = 7.2 ml.
That is, the daily dosage of Augmentin for a 1-month-old child weighing 6 kg is contained in 7.2 ml of suspension with a dose of 125/31.25. Since the child needs to be given a suspension twice a day, we divide 7.2/2 = 3.6 ml. This means that the baby needs to be given 3.6 ml of suspension twice a day.
Children aged 3 months to 12 years the suspension dosage is calculated using other ratios, but also taking into account body weight and the severity of the disease. Thus, the daily dosage for suspensions of various concentrations is calculated according to the following ratios:
In addition, for children of this age category, it is necessary to remember the following rule - a suspension with a concentration of 125/31.5 is given three times a day every 8 hours, and suspensions with dosages of 200/28.5 and 400/57 are given twice a day at intervals at 12 o'clock. Accordingly, to determine how much suspension should be given to a child, first the daily dosage of Augmentin in mg is calculated using the standard ratios indicated above, and then converted into milliliters of suspension with a particular concentration. After this, the resulting ml is divided into 2 or 3 doses per day.
Let's look at an example of calculating suspension dosages for children over 3 months old. So, a child weighing 20 kg suffers chronic tonsillitis. This means that he needs to take a suspension of 125 mg at 20 mg per 1 kg or suspensions of 200 mg and 400 mg at 25 mg per 1 kg. Let's calculate how many mg of active substance a child needs in suspensions of all concentrations:
1.
Suspension 125/31.25: 20 mg*20 kg = 400 mg per day;
2.
Suspensions 200/28.5 and 400/57: 25 mg * 20 kg = 500 mg per day.
For a suspension with a concentration of 125/31.25 mg:
400 mg in X ml
125 mg in 5 ml; X = 5*400/125 = 16 ml.
For a suspension with a concentration of 200/28.5:
500 mg in X ml
200 mg in 5 ml; X = 5*500/200 = 12.5 ml.
For a suspension with a concentration of 400/57 mg:
500 mg in X ml
400 mg in 5 ml; X = 5*500/400 = 6.25 ml.
This means that for a child weighing 10 kg suffering from tonsillitis, the daily dosage of a 125 mg suspension is 16 ml, a 200 mg suspension is 12.5 ml and a 400 mg suspension is 6.25 ml. Next we divide milliliters daily amount suspensions for 2 or 3 doses per day. For a suspension of 125 mg, divide by 3 and get: 16 ml/3 = 5.3 ml. For suspensions of 200 mg and 400 mg, divide by 2 and get: respectively, 12.5/2 = 6.25 ml and 6.25/2 = 3.125 ml. This means that the child should be given the following amount of the drug:
In addition to the indicated method for calculating the amount of suspension for each specific case, you can use standardized dosages corresponding to age and body weight. These standardized dosages are shown in the table.
| Child's age | Child's weight | Suspension 125/31.25 (take the indicated dose 3 times a day) | Suspensions 200/28.5 and 400/57 (take the indicated dose 2 times a day) |
| 3 months – 1 year | 2 – 5 kg | 1.5 – 2.5 ml | 1.5 – 2.5 ml of suspension 200 mg |
| 6 – 9 kg | 5 ml | 5 ml suspension 200 mg | |
| 1 – 5 years | 10 – 18 kg | 10 ml | 5 ml suspension 400 mg |
| 6 – 9 years | 19 – 28 kg | 15 ml or 1 tablet 250+125 mg 3 times a day | 7.5 ml of suspension 400 mg or 1 tablet 500+125 mg 3 times a day |
| 10 – 12 years | 29 – 39 kg | 20 ml or 1 tablet 250+125 mg 3 times a day | 10 ml of suspension 400 mg or 1 tablet 500+125 mg 3 times a day |
The tablets must be used within a month after opening the foil package. If there are any Augmentin tablets left 30 days after opening this package, they should be thrown away and not used. Augmentin tablets should be used by adults and children over 12 years of age with a body weight of at least 40 kg. The choice of tablet dosage is determined by the severity of the infection and does not depend on age and body weight.
Thus, for mild and moderate infections of any location, it is recommended to take 1 tablet of 250+125 mg 3 times a day every 8 hours for 7 to 14 days.
For severe infections (including chronic and recurrent genitourinary and respiratory organs) Augmentin tablets should be taken as follows:
In case of urgent need, you can replace the tablets with a suspension according to the following ratio: 1 tablet of 875+125 mg is equivalent to 11 ml of suspension 400/57 mg. There are no other options for replacing tablets with a suspension, since the dosages in them will not be equivalent.
Adults and children over 12 years old
Augmentin injections, depending on the severity of the infection, are administered in the following dosages: Before starting to use Augmentin, you must make sure that the person does not have allergic reactions to antibiotics of the penicillin and cephalosporin groups. If during the period of using Augmentin there is allergic reaction, then the drug should be stopped immediately and never used again.
Augmentin should not be used if infectious mononucleosis is suspected.
When taking Augmentin in high dosages, you should consume at least 2 - 2.5 liters of liquid per day so that it does not form in the urine large number crystals that can scratch the urethra during urination.
When using the suspension, be sure to brush your teeth several times a day to prevent staining.
In case of renal failure with creatinine clearance more than 30 ml/min, Augmentin should be taken in the usual dosages for the person’s age and weight. If creatinine clearance against the background of renal failure is less than 30 ml/min, then you can only take following forms Augmentina:
Probenecid leads to an increase in the concentration of Augmentin in the blood. Allopurinol when taken simultaneously with Augmentin increases the risk of developing skin reactions.
Augmentin increases the toxicity of methotrexate and reduces the effectiveness of combined oral contraceptives. Therefore, while using Augmentin, additional methods of contraception should be used.
On pharmaceutical market There is a wide range of Augmentin synonyms, which also contain amoxicillin and clavulanic acid as active ingredients. These synonymous drugs are called analogues based on the active substance. Such analogues of Augmentin based on the active substance include the following drugs:
Augmentin is a penicillin-based antibiotic that fights most infections and is approved for use by both adults and children. However, with the selection correct dosage Augmentin 400 suspension for children, as it turns out, causes a lot of problems for those young parents who act without the pediatrician’s recommendations or try to replace with this remedy what was prescribed by the doctor. It is from such mistakes that numerous negative reviews about the drug. How to understand all the intricacies and not harm yourself and your child?
The main components of Augmentin, regardless of its release form, are the antibiotic amoxicillin and the lactamase liquidator clavullinic acid. The main burden lies on amoxicillin: it is thanks to it that the drug has an antibacterial effect against almost any infection. However, it has a significant drawback - most pathogenic microorganisms quickly get used to it and stop responding, as a result of which an additional component is needed that will destroy the resistance of viruses. This component is clavullinic acid.
The main indications for taking Augmentin suspension are:
For administration, the Augmentin suspension is prepared according to the following algorithm:
The approximate price of the Augmentin 400 suspension ranges from 380-460 rubles.
The main difficulty is that, since there are 2 active ingredients in the drug, the concentration of each of them is indicated on the packaging. Thus, pharmacies offer the following options powdered "Augmentin":
Each proportion is aimed at 5 (!) ml of the finished suspension. In doctor’s prescriptions and the usual mention of the drug, “Agumentin” is called by more- 125, 200 or 400. Therefore, the dosage for children and adults is calculated based on the concentration of the antibiotic, not clavulinic acid. Thus, “Agumentin 125” and “Agumentin 200” are not interchangeable due to the non-identical ratio of active components. For proper treatment you need to choose exactly the option that was prescribed by the doctor.
Thus, if a child aged 7 years and weighing 26 kg needs 45 mg of Augmentin 400 per kg of weight for the treatment of otitis, then the total dosage will be 1170 mg, divided into 2 doses - 585 mg each. Taking into account the fact that 5 ml of the finished suspension will contain only 400 mg, you will need to make 7.3 ml per dose, or 14.6 ml per day. The exact calculation of the dosage of Augmentin 400 for children according to the instructions is not easy due to several mathematical operations, in which it is easy to get confused. To facilitate this process, the manufacturer offers average values, but they are not suitable for every organism and can only serve as a hint for those who are trying to understand whether they calculated everything correctly on their own.
The values are indicated for a single dose (for a daily dose, multiply by 2), but they do not take into account the severity of the disease.
As with all antibiotics, the attitude of patients (especially young parents) to Augmentin is extremely controversial: no one doubts that this medication should be used only in cases of extreme necessity, but sometimes even this need does not cover the shortcomings of the drug.
Inna: “Augmentin” is used only for bronchitis, which cannot be combated with anything less in painful ways, and we make it a component complex therapy. We take Augmentin suspension for 4 days, once a day, 5 ml (for a 3.5 year old child). After the antibiotic, we begin to restore the microflora (it is important not to do this at the same time as the antibiotic.
Olga: The pediatrician forced me to buy Augmentin when my son (6 years old) and I came to her for a certificate and some prescription to cure tonsillitis. She prescribed us 5 ml of suspension daily for a week. I trusted the specialist and tried to strictly follow the instructions: after the first dose, my son complained of nausea, but I did not attach any importance to this - he had a fever, and I attributed everything to it. But at night, after the second dose, the child became more nauseous and vomited. However, I only suspected problems with Augmentin the next day, when the vomiting became constant (we continued to drink the suspension). I had to cancel the treatment and visit the doctor again. It turned out that this is a fairly common adverse reaction.
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