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Evidence-based medicine, rational use of medicine
Community-acquired pneumonia in adults refers to inflammation of the lung parenchyma outside the hospital, including pneumonia with a definite incubation period in which pathogen infection with a defined incubation period develops during the incubation period after admission [1].
Amoxicillin/clavulanate potassium is the antimicrobial of choice for the treatment of outpatients with community-acquired pneumonia in adults [1-3].
Proficient in antibacterial properties
Amoxicillin/clavulanate potassium is a compound preparation of amoxicillin and clavulanate potassium, the ratio of amoxicillin to clavulanate varies from 2:1, 4:1, 5:1, 7:1, 8:1 and 10:1
.
Preparations include tablets, dispersants, capsules, granules, chewable tablets, dry suspensions, injections, etc
.
The antibacterial effect is strongest when the ratio of amoxicillin to clavulanate is 2:1[4].
Amoxicillin is a broad-spectrum penicillin antibiotic, clavulanate potassium (β-lactamase inhibitor) itself has only weak antibacterial activity, but has a strong broad-spectrum β lactamase inhibition, the combination of the two can protect amoxicillin from β lactamase hydrolysis
.
Its antimicrobial spectrum is the same as amoxicillin's and has expanded
.
Amoxicillin/clavulanate has good antibacterial effect on methicillin-sensitive staphylococcus, Enterococcus faecal, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Salmonella and other Enterobacteriaceae, Bacteroides fragilis, Fusobacterium and other anaerobic bacteria [5].
The drug prophylaxis hepatotoxic amoxicillin/clavulanate potassium may have hepatotoxic
reactions and may be probably liver damage
caused by potassium clavulanate.
In general, liver damage caused by this drug is mainly manifested as cholestatic hepatitis, and the symptoms are generally mild and reversible
.
However, individual cases can also cause serious liver damage and even death
.
It should be reminded that the incubation period of amoxicillin/clavulanate potassium hepatotoxicity is long, which can exceed 10 days, and some even develop several
weeks after stopping the drug.
Combined medication is a precipitating factor for the hepatotoxic reaction of amoxicillin/clavulanate potassium, especially when combined with hepatotoxic drugs (eg, acetaminophen, allopurinol, erythromycin, ciprofloxacin, nonsteroidal anti-inflammatory drugs, ethinylestradiol, etc
.
).
Liver dysfunction abnormalities due to amoxicillin/clavulanate potassium are more common
in older people, children, and patients with a prior history of hepatitis B.
Amoxicillin/clavulanate potassium is not preferred in patients with common bacterial infections and is usually not treated for more than 14 days
.
The incidence of hepatotoxicity in elderly men older than 65 years is high, so elderly men should be used with caution, or choose preparations with a reduced ratio of potassium clavulanate (7:1) [6-10].
More popular drugs in Corey, where to learn?
What is the difference between amoxicillin/clavulanate and amoxicillin?
What is the difference between amoxicillin/clavulanate in different proportions?
What is the medication of amoxicillin/clavulanate potassium?
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[1] Chinese Medical Association, Chinese Medical Association Clinical Pharmacy Branch, Chinese Medical Association Journal Society, Chinese Medical Association General Practice Branch, Chinese Medical Association "Chinese Journal of General Practitioners" Editorial Board, Expert Group for Rational Drug Use Guidelines for Primary Medical and Health Institutions.
Guidelines for rational drug use at the primary level for community-acquired pneumonia in adults[J].
Chinese Journal of General Practitioners,2020,19(9):783-791.
)
[2] CHEN Ping, XIE Yu.
Clinical efficacy of amoxicillin-clavulanate potassium in patients with community-acquired pneumonia and its effect on the level of inflammatory factors[J].
Anti-Infective Pharmacy,2018,15(11):1888-1890.
)
[3] HUANG Yuehua,PENG Wenting,XIE Jiangying.
Comparison of the efficacy of amoxicillin, clavulanate potassium and azithromycin in the treatment of community-acquired pneumonia in children[J].
Journal of Clinical Rational Drug Use,2020,13(13):92-93.
)
Expert consensus on the clinical application of β-lactam antibiotics/β-lactamase inhibitor combination preparations.
Expert consensus on the clinical application of β-lactam antibiotics/β-lactamase inhibitor combination preparations (2020 edition)[J].
Chinese Medical Journal,2020,100(10):738-747.
[5] Yang Jinying.
Clinical application of amoxicillin, clavulanate potassium[J].
Tianjin Pharmaceutical Science,2017,29(5):59-61.
)
[6] Amoxicillin clavulanate potassium instructions.
ZHANG Yan, FENG Hao, SUN Yanyan, et al.
Case analysis of acute liver injury in children with amoxicillin-clavulanate potassium-induced burns[J].
Straits Pharmacy,2022,34(2):173-175.
)
[8] XU Bingru.
Study on the adverse reactions of amoxicillin and amoxicillin-clavulanate potassium[J].
Chinese Medical Guide,2017,15(5):46-47.
)
[9] WANG Wenwen, YUAN Jiang Li, WANG Jun.
Comparative analysis of adverse reactions of amoxicillin and amoxicillin-clavulanate potassium in clinical application[J].
China Practical Medicine,2016,11(8):126-127.
)
[10] WANG Zhongshan, LIU Hong, WANG Huili, et al.
Rare adverse reactions of amoxicillin/clavulanate potassium[J].
Journal of Adverse Drug Reactions,2004,6(4):246-248.
)
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