Penicillins

Question 1

What is the chemical and clinical class of Amoxicillin/Clavanulate?

Answer 1

Beta lacatm/betalactamase inhibitor, penicillin

Question 2

What is the MOA of Amoxicillin/Clavanulate?

Answer 2

A: Binds to the penicillin binding protein in the cell wall which consequently prevents the cross-linking of the peptidoglycan layer. It is bactericidal, thus stopping the growth of and killing the bacteria.
C: prevents the breakdown of amoxicillin by betalactamases, acts as a decoy molecule

Question 3

What are some of the indications for Amoxicillin/Clavanulate?

Answer 3

• Low/moderate severity HAP
• Acute otitis media (if no response to Amox.)
• Acute sinusitis (if no response to amox.)

Question 4

List some alternative medications for the conditions treated by Amoxicillin/Clavanulate

Answer 4

Cerfuroximine, moxifloxacin, ciprofloxacin, clindamycin

Question 5

What is the typical dose of Amoxicillin/Clavanulate?

Answer 5

500mg-875mg q12h for 5-10 days - depending on the infection

Question 6

List some common and less common side effects of Amoxicillin/Clavanulate

Answer 6

Common: rash, increased liver enzymes, diarrhoea, nausea
Less common: electrolyte disturbances, bleeding, drowsiness, hallucinations

Question 7

What bacteria is A/C used to treat and comment on its spectrum of activity

Answer 7

E.coli (-)
S. Aureus (+)
S. Pneumoniae (+)
Broad spectrum

Question 8

When would you amend the dose of A/C?

Answer 8

In renal impairment

Question 9

What monitoring would you consider for this medication?

Answer 9

CrCl and liver enzyme levels