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Amoxicillin and clavulanate: Pediatric drug information

Amoxicillin and clavulanate: Pediatric drug information
(For additional information see "Amoxicillin and clavulanate: Drug information" and see "Amoxicillin and clavulanate: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Augmentin;
  • Augmentin ES-600
Brand Names: Canada
  • AG-Amoxi Clav;
  • APO-Amoxi Clav;
  • AURO-Amoxiclav;
  • Clavulin;
  • Clavulin-125F;
  • Clavulin-250F;
  • Clavulin-500F;
  • JAMP-Amoxi Clav;
  • M-Amoxi Clav;
  • PRO-Amoxi Clav;
  • SANDOZ Amoxi-Clav
Therapeutic Category
  • Antibiotic, Beta-lactam and Beta-lactamase Inhibitor Combination;
  • Antibiotic, Penicillin
Dosing: Neonatal

Dosage guidance:

Dosing: Dose is based on amoxicillin component.

Dosage form information: Not all products are interchangeable; using a product with the incorrect amoxicillin:clavulanate ratio could result in subtherapeutic clavulanate concentrations or severe diarrhea. Incidence of diarrhea appears to increase with clavulanate dose; some experts recommend not exceeding 10 mg clavulanate/kg/day when possible (Ref).

General dosing:

Oral: Neonates: 15 mg amoxicillin/kg/dose every 12 hours.

IV [Canadian product; not available in United States]: Neonates:

5:1 formulation: IV: 25 mg amoxicillin/kg/dose every 12 hours.

10:1 formulation: IV: 50 mg amoxicillin/kg/dose every 12 hours.

High-dose regimen for oral step-down treatment

High-dose regimen for oral step-down treatment (eg, culture-negative sepsis, susceptible Escherichia coli infection):

Neonates weighing ≥2 kg: Oral: 25 mg amoxicillin/kg/dose every 8 hours (Ref). Note: In the clinical study, the product used was the 4:1 amoxicillin:clavulanate ratio product; however, this resulted in daily clavulanate doses of 18.75 mg/kg/day; changes in defecation patterns were noted in 24% of patients in both the amoxicillin/clavulanate and the IV antibiotics groups (Ref).

Dosing: Pediatric

Dosage guidance:

Dosing: Dose is based on amoxicillin component; not all products are interchangeable; using a product with the incorrect amoxicillin:clavulanate ratio could result in subtherapeutic clavulanic acid concentrations or severe diarrhea. Incidence of diarrhea increases with clavulanate dose; some experts recommend not exceeding 10 mg clavulanate/kg/day or 125 mg clavulanate/dose (Ref).

Formulation should be chosen based on dosing strategy:

"Standard-dose" regimens (ie, ≤45 mg/kg/day):

2:1 formulations: amoxicillin 250 mg/clavulanate 125 mg. Note: Per the manufacturer, the amoxicillin 250 mg/clavulanate 125 mg tablet should only be used in patients ≥40 kg, due to the amoxicillin to clavulanate ratio.

4:1 formulations:

• amoxicillin 125 mg/clavulanate 31.25 mg

• amoxicillin 250 mg/clavulanate 62.5 mg

• amoxicillin 500 mg/clavulanate 125 mg.

7:1 formulations:

• amoxicillin 200 mg/clavulanate 28.5 mg

• amoxicillin 400 mg/clavulanate 57 mg

• amoxicillin 875 mg/clavulanate 125 mg.

"High-dose" regimens (ie, 80 to 90 mg/kg/day):

14:1 formulations: amoxicillin 600 mg/clavulanate 42.9 mg.

16:1 formulations (extended release): amoxicillin 1,000 mg/clavulanate 62.5 mg.

General dosing: Note: See indication-specific dosing; recommended doses may vary. General dosing determined by formulation amoxicillin:clavulanate ratio.

Immediate-release formulations:

Infants, Children, and Adolescents:

4:1 formulation: Oral: 20 to 40 mg amoxicillin/kg/day in divided doses every 8 hours; maximum daily dose: 1,500 mg/day (Ref).

7:1 formulation: Oral: 25 to 45 mg amoxicillin/kg/day in divided doses every 12 hours; maximum daily dose: 1,750 mg/day (Ref).

14:1 formulation: Oral: 90 mg amoxicillin/kg/day in divided doses every 12 hours; maximum daily dose: 4,000 mg/day (Ref).

Extended-release formulation (16:1): Children and Adolescents ≥40 kg: Oral: 2,000 mg amoxicillin every 12 hours (Ref).

Impetigo

Impetigo: Infants, Children, and Adolescents: Oral: 25 to 45 mg amoxicillin/kg/day in divided doses every 8 to 12 hours for 7 days. Maximum dose: Every-8-hour dosing: 500 mg amoxicillin/dose; every-12-hour dosing: 875 mg amoxicillin/dose (Ref).

Osteoarticular infection, acute

Osteoarticular infection, acute (eg, septic [bacterial] arthritis, osteomyelitis): Step-down therapy following parenteral treatment (targeted therapy for susceptible pathogen): Limited data available:

Infants, Children, and Adolescents: Oral: 120 mg amoxicillin/kg/day in divided doses every 6 to 8 hours; maximum daily dose: 3,000 mg amoxicillin/day; do not exceed 125 mg of clavulanate per dose (Ref). Minimum total duration (IV plus oral therapy) is 2 to 3 weeks for septic arthritis and 3 to 4 weeks for osteomyelitis; however, duration should be individualized based on several factors including causative pathogen, response to therapy, and normalization of inflammatory markers (Ref).

Otitis media, acute

Otitis media, acute (AOM):

High-dose regimen: Note: Preferred in the United States and when activity against penicillin-nonsusceptible Streptococcus pneumoniae is desired (Ref).

Infants ≥3 months, Children, and Adolescents: Oral suspension (600 mg per 5 mL; 14:1 ratio product): Oral: 80 to 90 mg amoxicillin/kg/day divided every 12 hours. Maximum dose has not been established for AOM; however, 4,000 mg/day has been suggested (Ref).

Standard-dose regimen: Note: Only for use in areas where rates of penicillin-nonsusceptible S. pneumoniae are known to be low (Ref).

Infants ≥3 months, Children, and Adolescents: Standard formulations (4:1 or 7:1 ratio products): Oral: 40 to 45 mg amoxicillin/kg/day in divided doses every 8 to 12 hours. Maximum daily dose: 1,750 mg/day (Ref).

Duration of therapy: For patients with severe or recurrent AOM, tympanic membrane perforation, or who are <2 years of age, treat for 10 days; for patients ≥2 years of age with mild to moderate, nonrecurrent disease without tympanic membrane perforation, shorter durations of 5 to 7 days may be sufficient (Ref).

Canadian recommendations: Note: A higher-ratio amoxicillin and clavulanate product (ie, 14:1 ratio, the amoxicillin 600 mg and clavulanate 42.9 mg per 5 mL product) is not available in Canada; the following dosing is recommended to target middle ear concentrations similar to those achieved with the high-dose regimen (Ref).

Infants ≥6 months and Children:

≤35 kg: Oral suspension (amoxicillin 400 mg and clavulanate 57 mg per 5 mL): Oral: 45 to 60 mg amoxicillin/kg/day in divided doses every 8 hours (Ref).

>35 kg: Tablet (amoxicillin 500 mg and clavulanate 125 mg per tablet): Oral: 500 mg amoxicillin every 8 hours (Ref).

Duration of therapy: For patients with severe or recurrent AOM, tympanic membrane perforation, or who are <2 years of age, treat for 10 days; for patients ≥2 years of age with mild to moderate, nonrecurrent disease without tympanic membrane perforation, shorter durations of 5 to 7 days may be sufficient (Ref).

Pneumonia, community-acquired

Pneumonia, community-acquired:

Infants ≥3 months, Children, and Adolescents:

Empiric therapy: Oral: 90 mg amoxicillin/kg/day in divided doses every 12 hours; maximum daily dose: 4,000 mg amoxicillin/day (Ref).

H. influenzae, beta-lactamase-positive strains; mild infection or step-down therapy:

Standard-dose regimen: Oral: 45 mg amoxicillin/kg/day in divided doses every 8 hours (Ref).

High-dose regimen: Oral: 90 mg amoxicillin/kg/day in divided doses every 12 hours (Ref).

Duration of therapy: For outpatient treatment of uncomplicated disease in patients who respond to therapy, 5 days of therapy is likely adequate (Ref). Longer duration (eg, total course of 7 to 10 days) may be necessary in patients who do not respond quickly to therapy or who have underlying comorbidities (eg, lung disease, immunosuppression) (Ref).

Rhinosinusitis, acute bacterial

Rhinosinusitis, acute bacterial:

Infants ≥3 months: Oral: 45 mg amoxicillin/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours.

Children and Adolescents:

Standard-dose regimen: Oral: 45 mg amoxicillin/kg/day in divided doses every 12 hours; maximum dose: 875 mg amoxicillin/dose (Ref).

High-dose regimen: Note: Recommended for patients who live in areas with high endemic rates of penicillin-nonsusceptible S. pneumoniae, have moderate to severe infections, attend daycare, are <2 years of age, were recently hospitalized, received antibiotics within the past month, or are immunocompromised, and/or if initial therapy fails (Ref).

Oral: 80 to 90 mg amoxicillin/kg/day in divided doses every 12 hours; maximum dose: 2,000 mg amoxicillin/dose (Ref).

Duration of therapy: Limited data exist to determine optimal duration; historically 10 days has been recommended, but recently some have suggested a duration as short as 5 days; some patients may require extended therapy (ie, 14 to 21 days) based on clinical resolution (Ref).

Streptococcus, group A; chronic carriage

Streptococcus, group A; chronic carriage: Limited data available: Note: Most individuals with chronic carriage do not require antibiotic treatment (Ref).

Children and Adolescents: Oral: 40 mg amoxicillin/kg/day in divided doses every 8 hours for 10 days; maximum daily dose: 2,000 mg amoxicillin/day (Ref).

Urinary tract infection

Urinary tract infection: Infants ≥2 months, Children, and Adolescents: Oral: 20 to 45 mg amoxicillin/kg/day in divided doses every 8 to 12 hours; maximum dose: 500 mg amoxicillin/dose (Ref). Duration of therapy should be individualized based on patient age, severity/extent of infection, and clinical response; typical duration is 7 to 14 days, though it may be as short as 3 to 5 days (eg, for uncomplicated cystitis in patients ≥2 years of age) (Ref).

IV dosing (Canadian labeling; not available in United States):

Note: Choice of formulation depends upon desired dosages of amoxicillin and clavulanate; for higher daily doses of amoxicillin (as may be used in the empiric coverage of Streptococcus pneumoniae), the 10:1 formulation is preferred to avoid unnecessary high clavulanate exposure.

5:1 formulation:

Infants <3 months or weighing <4 kg: IV: 25 mg amoxicillin/kg/dose every 12 hours.

Infants ≥3 months weighing ≥4 kg, Children, and Adolescents: IV: 25 mg amoxicillin/kg/dose every 8 hours; maximum dose: 1,000 mg amoxicillin/dose.

10:1 formulation:

Infants <3 months or weighing <4 kg: IV: 50 mg amoxicillin/kg/dose every 12 hours.

Infants ≥3 months, Children, and Adolescents weighing 4 to <40 kg: 50 mg amoxicillin/kg/dose every 8 hours; maximum dose: 2,000 mg amoxicillin/dose.

Children and Adolescents weighing ≥40 kg: 2,000 mg amoxicillin every 8 to 12 hours.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Oral:

Infants, Children, and Adolescents: There are no dosage adjustments provided in the manufacturer's labeling; however, the following has been used by some clinicians (Ref). The manufacturer recommends to avoid the 875 mg immediate-release tablets and extended-release tablets if GFR <30 mL/minute.

Standard-dose regimens: Dosing based on 20 to 40 mg amoxicillin/kg/day divided every 8 hours or 25 to 45 mg amoxicillin/kg/day divided every 12 hours:

GFR ≥30 mL/minute/1.73 m2: No adjustment required.

GFR 10 to 29 mL/minute/1.73 m2: Oral: 8 to 20 mg amoxicillin/kg/dose every 12 hours.

GFR <10 mL/minute/1.73 m2: Oral: 8 to 20 mg amoxicillin/kg/dose every 24 hours.

Hemodialysis: Oral: 8 to 20 mg amoxicillin/kg/dose every 24 hours; give after dialysis.

Peritoneal dialysis: Oral: 8 to 20 mg amoxicillin/kg/dose every 24 hours.

High-dose regimens: Dosing based on 80 to 90 mg amoxicillin/kg/day divided every 12 hours:

CrCl >30 mL/minute/1.73 m2: No adjustment required.

CrCl 10 to 29 mL/minute/1.73 m2: Oral: 20 mg amoxicillin/kg/dose every 12 hours.

CrCl <10 mL/minute/1.73 m2: Oral: 20 mg amoxicillin/kg/dose every 24 hours.

Hemodialysis: Oral: 20 mg amoxicillin/kg/dose every 24 hours; give after dialysis.

Peritoneal dialysis: Oral: 20 mg amoxicillin/kg/dose every 24 hours.

IV [Canadian product]:

5:1 formulation:

Infants, Children, and Adolescents weighing <40 kg:

CrCl >30 mL/minute: No dosage adjustment necessary.

CrCl 10 to 30 mL/minute: IV: 25 mg amoxicillin/kg every 12 hours.

CrCl <10 mL/minute: IV: 25 mg amoxicillin/kg every 24 hours.

Hemodialysis: IV: 25 mg amoxicillin/kg every 24 hours; give an additional dose of 12.5 mg amoxicillin/kg at the end of each dialysis session.

Children and Adolescents weighing ≥40 kg:

CrCl >30 mL/minute: No dosage adjustment necessary.

CrCl 10 to 30 mL/minute: IV: 1,000 mg amoxicillin followed by 500 mg amoxicillin every 12 hours.

CrCl <10 mL/minute: IV: 1,000 mg amoxicillin followed by 500 mg amoxicillin every 24 hours.

Hemodialysis: IV: 1,000 mg amoxicillin followed by 500 mg amoxicillin every 24 hours; give an additional 500 mg at the end of each dialysis session.

10:1 formulation:

Infants, Children, and Adolescents:

CrCl >30 mL/minute: No dosage adjustment necessary.

CrCl <30 mL/minute: Use not recommended due to lack of data; preferred formulation is 5:1 with this level of kidney impairment.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling; use with caution. Use is contraindicated in patients with a history of amoxicillin and clavulanate-associated hepatic dysfunction.

Dosing: Adult

(For additional information see "Amoxicillin and clavulanate: Drug information")

Dosage guidance:

Dosing: Dose is based on the amoxicillin component.

Dosage form information: Dose and frequency are product specific; not all products are interchangeable. For adults who have difficulty swallowing the tablets, oral suspension in the appropriate amount may be given.

Usual dosing range:

Oral: Immediate release: 500 mg every 8 to 12 hours or 875 mg every 12 hours; Extended release: 2 g every 12 hours.

IV [Canadian product]: 1 g every 8 hours or 2 g every 8 to 12 hours; surgical prophylaxis: 1 to 2 g at induction of anesthesia for procedures <1 hour (for procedures >1 hour may administer up to 2 additional doses in 24 hours; do not exceed 3 g in 24 hours).

Bite wound infection, prophylaxis or treatment

Bite wound infection, prophylaxis or treatment (animal or human bite) (off-label use): Oral: Immediate release: 875 mg every 12 hours (Ref). For prophylaxis, duration is 3 to 5 days (Ref); for treatment of established infection, duration is typically 5 to 14 days and varies based on clinical response and patient-specific factors (Ref).

Chronic obstructive pulmonary disease, acute exacerbation

Chronic obstructive pulmonary disease, acute exacerbation: Note: Some experts reserve for patients with risk factors for poor outcomes (eg, ≥65 years of age, FEV1 <50% predicted, frequent exacerbations, major comorbidities), but low risk of Pseudomonas infection (Ref).

Oral: Immediate release: 500 mg every 8 hours or 875 mg every 12 hours for 5 to 7 days (Ref).

Diabetic foot infection

Diabetic foot infection (off-label use): Note: May be used alone for mild infections or after clinical response to parenteral therapy in patients without risk factors or concern for infection caused by Pseudomonas aeruginosa (Ref).

Oral: Immediate release: 875 mg every 12 hours (Ref). Duration of therapy depends on severity and clinical response; most patients with infection limited to skin and soft tissue respond to 1 to 2 weeks of therapy (Ref).

Intra-abdominal infection, mild to moderate, community-acquired in patients without risk factors for resistance or treatment failure

Intra-abdominal infection, mild to moderate, community-acquired in patients without risk factors for resistance or treatment failure (off-label use):

Diverticulitis, acute (for uncomplicated infection that meets criteria for outpatient therapy or as step-down therapy after clinical improvement on initial parenteral therapy):

Note: Some experts suggest deferring antibiotics in otherwise healthy patients who are immunocompetent with mild disease (Ref).

Immediate release: Oral: 875 mg every 8 hours (Ref).

Extended release: Oral: 2 g every 12 hours (Ref).

Other intra-abdominal infection, step-down therapy (when clinically improved and able to tolerate oral therapy) : Oral: Immediate release: 875 mg 2 to 3 times daily (Ref).

Duration: Total duration of therapy is 4 to 5 days following adequate source control (Ref). For diverticulitis or uncomplicated appendicitis managed without intervention, duration is 10 to 14 days (Ref); for perforated appendicitis managed with laparoscopic appendectomy, 2 to 4 days may be sufficient (Ref).

Neutropenic fever, low-risk patients with cancer

Neutropenic fever, low-risk patients with cancer (empiric therapy) (off-label use): Oral: Immediate release: 500 mg every 8 hours (Ref) or 875 mg every 12 hours (Ref). Combine either dosing regimen with oral ciprofloxacin; continue until resolution of fever and neutropenia. Note: Avoid in patients who have received fluoroquinolone prophylaxis. Administer first dose in the health care setting (after blood cultures are drawn); observe patient for ≥4 hours before discharge (Ref).

Odontogenic infection

Odontogenic infection (off-label use):

Acute simple gingivitis, plaque-associated: Note: Reserve systemic therapy for patients with rapidly progressive disease, severe pain, or immunocompromising conditions (Ref).

Oral: Immediate release: 875 mg every 12 hours or 500 mg every 8 hours for 5 to 7 days (Ref).

Periodontitis, severe, plaque-associated: Oral: Immediate release: 875 mg every 12 hours or 500 mg every 8 hours for 14 days or until clinical resolution, whichever is longer; use in addition to periodontal debridement (Ref).

Pyogenic odontogenic soft tissue infection (initial therapy for mild infection or step-down therapy after parenteral treatment): Oral: Immediate release: 875 mg every 12 hours or 500 mg every 8 hours; continue until clinical resolution, typically for 7 to 14 days. Use in addition to appropriate surgical management (eg, drainage and/or extraction) (Ref).

Otitis media, acute

Otitis media, acute:

Immediate release: Oral: 875 mg twice daily (Ref) or 500 mg every 8 hours (Ref).

Extended release: Oral: 1 or 2 g twice daily, based on weight and severity of infection; some experts prefer the extended release formulation for patients at high risk of severe infection or resistant S. pneumoniae (Ref).

Duration: 5 to 7 days for mild to moderate infection and 10 days for severe infection (Ref).

Peritonsillar cellulitis or abscess

Peritonsillar cellulitis or abscess (off-label-use): Note: For step-down therapy after parenteral treatment. Limited data available; dosing based on expert opinion. Oral: Immediate release: 875 mg every 12 hours to complete a total of 14 days of therapy (Ref).

Pneumonia

Pneumonia:

Aspiration pneumonia (community acquired [mild]):

Immediate release: Oral: 875 mg twice daily (Ref).

Extended release: Oral: 2 g twice daily (Ref).

Duration of therapy: Generally 5 days (Ref).

Community-acquired pneumonia:

Note: For empiric therapy in outpatients with comorbidities or oral step-down therapy following initial parenteral therapy in patients who are hospitalized (Ref).

Immediate release: Oral: 500 mg 3 times daily or 875 mg twice daily as part of an appropriate combination regimen (Ref).

Extended release: Oral: 2 g twice daily as part of an appropriate combination regimen (Ref).

Duration of therapy: Minimum of 5 days; patients should be clinically stable with normal vital signs before therapy is discontinued (Ref).

Rhinosinusitis, acute bacterial

Rhinosinusitis, acute bacterial:

Note: In uncomplicated acute bacterial rhinosinusitis, initial observation and symptom management without antibiotic therapy is appropriate in most patients. Reserve antibiotic therapy for poor follow-up or lack of improvement over the observation period (Ref).

Standard dose: Oral: Immediate release: 500 mg every 8 hours or 875 mg every 12 hours for 5 to 7 days (Ref).

High dose: Oral: Extended release: 2 g every 12 hours for 5 to 7 days. Note: Recommended for patients at risk for poor outcome or pneumococcal resistance based on the following features: ≥65 years of age, recent hospitalization or antibiotic use, multiple comorbidities, high endemic resistance (Ref).

Streptococcus, chronic carriage

Streptococcus (group A), chronic carriage (off-label use): Oral: Immediate release: 40 mg/kg/day in divided doses (eg, 875 mg every 12 hours) (maximum: 2 g/day) for 10 days (Ref). Note: Most individuals with chronic carriage do not require antibiotics (Ref).

Urinary tract infection

Urinary tract infection (alternative agent):

Note: Use only when preferred first-line agents cannot be used; limited evidence suggests inferior efficacy of oral beta-lactams (Ref).

Cystitis, acute uncomplicated or acute simple cystitis (infection limited to the bladder without signs/symptoms of upper tract, prostate, or systemic infection) : Oral: Immediate release: 500 mg twice daily (Ref) for 5 to 7 days (Ref).

Urinary tract infection, complicated (including pyelonephritis) : Oral: Immediate release: 875 mg twice daily for 10 to 14 days (Ref); for patients with symptomatic improvement within the first 48 to 72 hours of therapy, some experts recommend shorter courses of 7 to 10 days (Ref). Note: Oral beta-lactam therapy should generally follow appropriate parenteral therapy (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Oral:

Note: Renally adjusted dose recommendations are based on the amoxicillin component of the amoxicillin 250 mg/clavulanate 125 mg and amoxicillin 500 mg/clavulanate 125 mg tablets. Avoid IR 875 mg tablet or ER tablets in patients with CrCl <30 mL/minute.

Altered kidney function: Note: Although the manufacturer's labeling for some products utilizes the term GFR to present dose adjustment cutoffs, pharmacokinetic studies utilized CrCl measurements (Ref).

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl 10 to <30 mL/minute: 250 to 500 mg every 12 hours.

CrCl <10 mL/minute: 250 to 500 mg every 12 to 24 hours (Ref).

Hemodialysis, intermittent (thrice weekly): Dialyzable (30% to 47% [amoxicillin component], 34% [clavulanic acid] with low-flux filters (Ref)): 250 to 500 mg every 12 to 24 hours (Ref). If utilizing a 24-hour dosing interval, administer dose after dialysis or give an additional dose after dialysis on dialysis days.

Peritoneal dialysis: 250 to 500 mg every 12 hours (Ref).

IV [Canadian product]: Note: Dose based on amoxicillin component.

Altered kidney function:

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl 10 to 30 mL/minute: Initial: 1 g followed by 500 mg every 12 hours.

CrCl <10 mL/minute: Initial: 1 g followed by 500 mg every 12 to 24 hours (Ref).

Hemodialysis, intermittent (thrice weekly): Dialyzable (30% to 47% [amoxicillin component] with low-flux filters (Ref)): Initial: 1 g followed by 500 mg every 12 to 24 hours. If utilizing a 24-hour dosing interval, administer dose after dialysis or give an additional 500 mg dose after dialysis on dialysis days (Ref).

Peritoneal dialysis: Initial: 1 g followed by 500 mg every 12 hours (Ref).

Dosing: Hepatic Impairment: Adult

Oral, IV [Canadian product]: There are no dosage adjustments provided in the manufacturer's labeling; use with caution. Use contraindicated in patients with a history of amoxicillin and clavulanate-associated hepatic dysfunction.

Adverse Reactions (Significant): Considerations
Antibiotic-associated (non-Clostridioides difficile) diarrhea

GI effects range from antibiotic-associated [non-C.diff] diarrhea (AAD), nausea, and vomiting. Most cases of AAD are mild and self-limiting (Mullish 2018). However, Clostridioides difficile may account for as many as >20% of cases in children, adolescents, and adults (discussed separately) (Ref).

Mechanism: Dose- and time-related. In addition to antibiotic disruption of indigenous gut microbiota, clavulanic acid appears to stimulate small-bowel motility (Ref).

Onset: Varied; mean time to onset of AAD is 3 to 18 days for adult patients and 2 to 6 days for pediatric patients. The majority of AAD cases occur during (versus after) antibiotic therapy in pediatric patients (Ref).

Risk factors:

• More common with amoxicillin/clavulanic acid than with amoxicillin or ampicillin alone (Ref)

• More frequent dosing (eg, 3 times daily versus twice daily) and higher amounts of clavulanic acid (eg, high-dose amoxicillin/clavulanate) may increase risk in pediatric patients (Ref)

• Duration of therapy (Ref)

• Age (pediatric patients <2 years of age and older adults) (Ref)

• Length of hospitalization or ICU stay (Ref)

• Duration of proton pump inhibitor use (Ref)

• Parenteral nutrition (Ref)

• Combinations of antibiotics (Ref)

Clostridioides difficile infection

Clostridioides difficile infection (CDI) has occurred, including Clostridioides difficile associated diarrhea and Clostridioides difficile colitis. (Ref)

Onset: Varied; may start on the first day of antibiotic therapy or up to 3 months postantibiotic (Ref).

Risk factors:

• Antibiotic exposure (highest risk factor), especially prolonged use (Ref)

• Type of antibiotic (penicillin combination antibiotics, including amoxicillin and clavulanate, have been associated with increased risk) (Ref)

• Long durations in a hospital or other healthcare setting (recent or current) (Ref)

• Older adults (Ref)

• Immunocompromised conditions (Ref)

• A serious underlying condition (Ref)

• GI surgery/manipulation (Ref)

• Antiulcer medications (eg, proton pump inhibitors and H2 blockers) (Ref)

• Chemotherapy (Ref)

• In pediatric patients, community-acquired CDI was associated with amoxicillin/clavulanate, cephalosporins, or clindamycin use in the prior 12 weeks, as well as non-Hispanic race, more health care visits, and prior positive Clostridioides difficile test in the past 6 months (Ref).

Drug-induced liver injury

Although rarely fatal, drug-induced liver injury has been reported. The most frequent presentation is cholestatic hepatitis (Ref). Most patients recover after drug discontinuation, but there are reports of death or patients who require liver transplantation (Ref)

Mechanism: Non-dose-related; primarily immunologic, mediated by T-cells (Ref). Genetic variation at human leukocyte antigen class I & II loci has been shown to be associated with amoxicillin/clavulanic acid induced liver jury (Ref). Unknown whether the liver injury is due to amoxicillin or clavulanic acid or both (Ref).

Onset: Variable; most cases occur within 12 weeks after initial drug exposure (Ref).

Risk factors:

• Older male patients, most often of Caucasian race, are at greater risk (Ref)

• Serious underlying disease

• Concomitant medications (Ref)

• Repeated courses of therapy (Ref)

Hypersensitivity (immediate and delayed)

Immediate, including urticaria, angioedema and anaphylaxis (Ref), and delayed hypersensitivity reactions have been reported in all ages (Ref). Delayed hypersensitivity reactions range from maculopapular skin rash to rare severe cutaneous adverse reactions (SCARs), including acute generalized exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necrolysis in all ages (Ref).

Mechanism: Non-dose-related; immunologic. Immediate hypersensitivity reactions (eg, anaphylaxis, urticaria) are IgE-mediated. Delayed hypersensitivity reactions, including maculopapular rash and SCARs are T-cell-mediated (Ref). In patients with reactions to amoxicillin/clavulanic acid, the reaction can be mediated by the amoxicillin or clavulanic acid component (Ref), or some patients may be sensitized independently to both amoxicillin and clavulanic acid (Ref). Approximately 30% of patients have selective reactions to clavulanic acid (Ref).

Onset: Immediate hypersensitivity reactions: Rapid; generally occur within 1 hour of administration but may occur up to 6 hours after exposure (Ref). Delayed hypersensitivity reactions: Maculopapular reactions: Intermediate; occur 7 to 10 days after initiation. Other reactions (including SCARs): Variable; occur after 7 to 14 days up to 3 months) (Ref).

Risk factors:

• Rash may develop in 9% to 23% of patients with Epstein-Barr virus (EBV) infection (infectious mononucleosis) who are not on antibiotics. Although previous studies indicated that concomitant administration of an aminopenicillin, specifically ampicillin or amoxicillin, may increase the risk of rash in these patients, more recent studies suggest that amoxicillin/clavulanic acid may not increase the risk of rash. In one study, 12.5% of EBV-infected patients who used amoxicillin/clavulanic acid developed a rash (Ref).

• Cross-reactivity between beta-lactams (related to side chain similarity) (Ref). No cross-reactivity reported between clavulanic acid and penicillins, likely due to differences in chemical structures (Ref).

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Gastrointestinal: Diarrhea (3% to 34%)

1% to 10%:

Dermatologic: Candidal diaper rash (4% to 6%), diaper rash (4%), skin rash (≤3%), urticaria (≤3%)

Gastrointestinal: Nausea (2% to 3%), vomiting (1% to 2%)

Genitourinary: Vaginal mycosis (3%), vaginitis (1%)

Infection: Candidiasis (1%)

<1%:

Gastrointestinal: Abdominal distress, flatulence

Hematologic & oncologic: Thrombocytosis

Nervous system: Headache

Postmarketing:

Dermatologic: Acute generalized exanthematous pustulosis (Hioki 2019), bullous dermatitis (linear IgA) (Panasiti 2009), erythema multiforme (Peng 2013), exfoliative dermatitis (Barni 2018), fixed drug eruption (Perez-Ezquerra 2010), pruritus, Stevens-Johnson syndrome (Mori 2017), Sweet syndrome (histiocytoid) (Yuksek 2022), toxic epidermal necrolysis (Rodriguez-Martin 2019)

Gastrointestinal: Clostridioides difficile colitis, Clostridioides difficile-associated diarrhea (Brown 2020; Slimings 2014), dyspepsia, enterocolitis (including drug-induced enterocolitis syndrome [DIES]) (Freundt Serpa 2020), gastritis, glossitis, hemorrhagic colitis (Youn 2018), melanoglossia, mucocutaneous candidiasis, pancreatitis (Chams 2018), staining of tooth (Garcia-Lopez 2001), stomatitis

Genitourinary: Crystalluria (van Noord 2012), hematuria (Asim 2021)

Hematologic & oncologic: Agranulocytosis (Armas Villalba 2019), anemia, eosinophilia, hemolytic anemia, immune thrombocytopenia, leukopenia, thrombocytopenia (Mansour 2014)

Hepatic: Acute hepatic failure (Fontana 2005), cholestatic hepatitis (Chalasani 2014; deLemos 2016), hepatocellular hepatitis (Chalasani 2014; deLemos 2016), jaundice (deLemos 2016)

Hypersensitivity: Anaphylaxis (including Kounis syndrome) (Moloney 2019), angioedema (Salvo 2007), drug reaction with eosinophilia and systemic symptoms (van Kester 2018), hypersensitivity angiitis, nonimmune anaphylaxis, serum sickness-like reaction (Patterson-Fortin 2016), type IV hypersensitivity reaction (Copaescu 2020)

Nervous system: Agitation, anxiety, aseptic meningitis (Chandler 2019), behavioral changes (Macknin 1987), confusion, dizziness, insomnia, myoclonus (Viloria-Alebesque 2020), reversible hyperactivity

Renal: Interstitial nephritis (including acute interstitial nephritis; can be hemorrhagic) (Asim 2021)

Contraindications

Hypersensitivity to amoxicillin, clavulanic acid, other beta-lactam antibacterial drugs (eg, penicillins, cephalosporins), or any component of the formulation; history of cholestatic jaundice or hepatic dysfunction with amoxicillin/clavulanate potassium therapy.

Augmentin XR: Additional contraindications: Severe renal impairment (CrCl <30 mL/minute) and patients on hemodialysis.

Canadian labeling: Additional contraindications (not in the US labeling): Suspected or confirmed mononucleosis.

Warnings/Precautions

Concerns related to adverse effects:

• Superinfection: Prolonged use may result in fungal or bacterial superinfection.

Dosage form specific issues:

• Clavulanic acid content: Due to differing content of clavulanic acid, not all formulations are interchangeable; use of an inappropriate product for a specific dosage could result in either diarrhea (which may be severe) or subtherapeutic clavulanic acid concentrations leading to decreased clinical efficacy.

• Phenylalanine: Some products contain phenylalanine.

Warnings: Additional Pediatric Considerations

Diarrhea has been reported with amoxicillin and clavulanate; incidence increases with clavulanate dose. Some experts recommend not exceeding 10 mg clavulanate/kg/day, 5 mg clavulanate/kg/dose, or 125 mg clavulanate/dose (Yu 2022). In a study of patients 6 to 23 months of age with acute otitis media (n=112), patients who received amoxicillin 80 mg/kg/day and clavulanate 2.85 mg/kg/day (novel formulation not currently available) experienced less diarrhea and diaper dermatitis but similar efficacy as compared to historical controls receiving amoxicillin 90 mg/kg/day and clavulanate 6.4 mg/kg/day (Hoberman 2017). Minimum dose requirement for optimal inhibition of beta-lactamases and pharmacodynamic predictor of efficacy for clavulanate have not been defined (Crass 2019). Dosing per manufacturer's labeling for patients <40 kg results in a clavulanate dose of 3.6 to 10 mg/kg/day (4:1 ratio formulations: 5 to 10 mg/kg/day; 7:1 ratio formulations: 3.6 to 6.4 mg/kg/day; 14:1 formulation: 6.4 mg/kg/day).

Dosage Forms Considerations

IV [Canadian product]: 500 mg, 1 g, and 2 g vials contain 31.4 mg (1.4 mmoL), 62.9 mg (2.7 mmoL), and 125.9 mg (5.5 mmoL) of sodium and 19.6 (0.5 mmoL), 39.3 mg (1 mmoL) and 39.3 mg (1 mmoL) of potassium, respectively.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Suspension Reconstituted, Oral:

Augmentin: Amoxicillin 250 mg and clavulanate potassium 62.5 mg per 5 mL (75 mL [DSC], 100 mL [DSC], 150 mL [DSC]); Amoxicillin 125 mg and clavulanate potassium 31.25 mg per 5 mL (75 mL [DSC], 100 mL [DSC], 150 mL [DSC]) [contains saccharin sodium]

Augmentin: Amoxicillin 125 mg and clavulanate potassium 31.25 mg per 5 mL (100 mL, 150 mL) [contains saccharin sodium; banana flavor]

Augmentin ES-600: Amoxicillin 600 mg and clavulanate potassium 42.9 mg per 5 mL (75 mL [DSC], 125 mL [DSC], 200 mL [DSC]) [contains aspartame; strawberry cream flavor]

Generic: Amoxicillin 200 mg and clavulanate potassium 28.5 mg per 5 mL (50 mL, 75 mL, 100 mL); Amoxicillin 250 mg and clavulanate potassium 62.5 mg per 5 mL (75 mL, 100 mL, 150 mL); Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL (50 mL, 75 mL, 100 mL); Amoxicillin 600 mg and clavulanate potassium 42.9 mg per 5 mL (75 mL, 125 mL, 200 mL)

Suspension Reconstituted, Oral [preservative free]:

Augmentin ES-600: Amoxicillin 600 mg and clavulanate potassium 42.9 mg per 5 mL (200 mL) [contains aspartame; strawberry cream flavor]

Tablet, Oral:

Augmentin: Amoxicillin 500 mg and clavulanate potassium 125 mg

Generic: Amoxicillin 250 mg and clavulanate potassium 125 mg, Amoxicillin 500 mg and clavulanate potassium 125 mg, Amoxicillin 875 mg and clavulanate potassium 125 mg

Tablet Chewable, Oral:

Generic: Amoxicillin 200 mg and clavulanate potassium 28.5 mg, Amoxicillin 400 mg and clavulanate potassium 57 mg

Tablet Extended Release 12 Hour, Oral:

Generic: Amoxicillin 1000 mg and clavulanate potassium 62.5 mg

Generic Equivalent Available: US

Yes

Pricing: US

Chewable (Amoxicillin-Pot Clavulanate Oral)

200-28.5 mg (per each): $3.08

400-57 mg (per each): $5.88

Suspension (reconstituted) (Amoxicillin-Pot Clavulanate Oral)

200-28.5 mg/5 mL (per mL): $0.36 - $0.39

250-62.5 mg/5 mL (per mL): $0.86 - $0.88

400-57 mg/5 mL (per mL): $0.69 - $0.74

600-42.9 mg/5 mL (per mL): $0.49 - $0.68

Suspension (reconstituted) (Augmentin ES-600 Oral)

600-42.9 mg/5 mL (per mL): $5.49

Suspension (reconstituted) (Augmentin Oral)

125-31.25 mg/5 mL (per mL): $7.21

Tablet, 12-hour (Amoxicillin-Pot Clavulanate ER Oral)

1000-62.5 mg (per each): $7.67

Tablets (Amoxicillin-Pot Clavulanate Oral)

250-125 mg (per each): $5.92

500-125 mg (per each): $3.78 - $6.00

875-125 mg (per each): $5.05 - $9.00

Tablets (Augmentin Oral)

500-125 mg (per each): $11.57

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution Reconstituted, Intravenous:

Generic: Amoxicillin 1000 mg and clavulanate potassium 200 mg (1 ea); Amoxicillin 2000 mg and clavulanate potassium 200 mg (1 ea); Amoxicillin 500 mg and clavulanate potassium 100 mg (1 ea)

Suspension Reconstituted, Oral:

Clavulin: Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL (70 mL); Amoxicillin 200 mg and clavulanate potassium 28.5 mg per 5 mL (70 mL)

Clavulin-125F: Amoxicillin 125 mg and clavulanate potassium 31.25 mg per 5 mL (100 mL, 150 mL)

Clavulin-250F: Amoxicillin 250 mg and clavulanate potassium 62.5 mg per 5 mL (100 mL, 150 mL)

Generic: Amoxicillin 125 mg and clavulanate potassium 31.25 mg per 5 mL ([DSC]); Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL (70 mL)

Tablet, Oral:

Clavulin: Amoxicillin 875 mg and clavulanate potassium 125 mg

Clavulin-500F: Amoxicillin 500 mg and clavulanate potassium 125 mg

Generic: Amoxicillin 250 mg and clavulanate potassium 125 mg, Amoxicillin 500 mg and clavulanate potassium 125 mg, Amoxicillin 875 mg and clavulanate potassium 125 mg

Administration: Pediatric

Oral: Immediate-release formulations may be given without regard to meals; however, administer at the start of a meal to decrease the frequency or severity of GI side effects and improve absorption; administer extended-release tablet at the start of a meal. Shake suspension well before use.

IV [Canadian product]: Administer as an infusion over 30 to 40 minutes. In infants ≥3 months, children, and adolescents, 5:1 formulations (500/100 mg and 1,000/200 mg) may also be administered by slow IV injection over 3 to 4 minutes.

Administration: Adult

Oral: Administer around-the-clock to promote less variation in peak and trough serum levels. Administer with food to increase absorption and decrease stomach upset; shake suspension well before use. ER tablets should be administered with food.

Bariatric surgery: Tablet, extended release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Do not cut, crush, or chew. Switch to IR formulation.

IV [Canadian product]: Administer by slow IV injection over 3 to 4 minutes (500 mg or 1 g dose only) or as an infusion over 30 to 40 minutes.

Storage/Stability

Oral:

Powder for oral suspension: Store dry powder at or below 25°C (77°F). Reconstituted oral suspension should be kept in refrigerator. Discard unused suspension after 10 days (consult manufacturer's labeling for specific recommendations). Unit-dose antibiotic oral syringes are stable under refrigeration for 24 hours (Tu 1988).

Tablet: Store at or below 25°C (77°F). Dispense in original container.

IV [Canadian product]: Store intact vials at 15°C to 30°C (59°F to 86°F). Store reconstituted solution at 15°C to 30°C (59°F to 86°F) for up to 15 minutes. Solutions diluted for infusion should be used within 1 hour if stored at 25°C (77°F) or within 4 hours if stored at 4°C (30°F); recommendations may vary based on solution used for dilution, refer to manufacturer’s labeling for detailed information.

Use

Treatment of lower respiratory tract infections, acute otitis media, sinusitis, skin and soft tissue infections, and urinary tract infections caused by susceptible bacteria (FDA approved in all ages).

Note: Approved indications and ages may vary by product; consult product-specific labeling for details.

Powder for oral suspension:

Amoxicillin 125 mg/clavulanate 31.25 mg/5 mL (4:1): FDA approved in all ages.

Amoxicillin 200 mg/clavulanate 28.5 mg/5 mL (7:1): FDA approved in ages ≥3 months and adults.

Amoxicillin 250 mg/clavulanate 62.5 mg/5 mL (4:1): FDA approved in ages ≥3 months and adults.

Amoxicillin 400 mg/clavulanate 57 mg/5 mL (7:1): FDA approved in ages ≥3 months and adults.

Amoxicillin 600 mg/clavulanate 42.9 mg/5 mL (14:1): FDA approved in pediatric patients ≥3 months and <40 kg.

Tablet, chewable:

Amoxicillin 200 mg/clavulanate 28.5 mg (7:1): FDA approved in pediatric patients (age not specified).

Amoxicillin 400 mg/clavulanate 57 mg (7:1): FDA approved in pediatric patients (age not specified).

Tablet, oral:

Amoxicillin 250 mg/clavulanate 125 mg (2:1): FDA approved in pediatric patients ≥40 kg and adults.

Amoxicillin 500 mg/clavulanate 125 mg (4:1): FDA approved in pediatric patients ≥40 kg and adults.

Amoxicillin 875 mg/clavulanate 125 mg (7:1): FDA approved in pediatric patients ≥40 kg and adults.

Extended-release tablet: Amoxicillin 1,000 mg/clavulanate 62.5 mg (16:1): FDA approved in pediatric patients ≥40 kg and adults.

Medication Safety Issues
Sound-alike/look-alike issues:

Augmentin may be confused with amoxicillin, Azulfidine

Metabolism/Transport Effects

Refer to individual components.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Acemetacin: May increase the serum concentration of Penicillins. Risk C: Monitor therapy

Allopurinol: May enhance the potential for allergic or hypersensitivity reactions to Amoxicillin. Risk C: Monitor therapy

Aminoglycosides: Penicillins may decrease the serum concentration of Aminoglycosides. Primarily associated with extended spectrum penicillins, and patients with renal dysfunction. Risk C: Monitor therapy

Bacillus clausii: Antibiotics may diminish the therapeutic effect of Bacillus clausii. Management: Bacillus clausii should be taken in between antibiotic doses during concomitant therapy. Risk D: Consider therapy modification

BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical). Risk X: Avoid combination

BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Risk C: Monitor therapy

Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid combination

Dichlorphenamide: Penicillins may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy

Fecal Microbiota (Live) (Oral): May diminish the therapeutic effect of Antibiotics. Risk X: Avoid combination

Fecal Microbiota (Live) (Rectal): Antibiotics may diminish the therapeutic effect of Fecal Microbiota (Live) (Rectal). Risk X: Avoid combination

Immune Checkpoint Inhibitors (Anti-PD-1, -PD-L1, and -CTLA4 Therapies): Antibiotics may diminish the therapeutic effect of Immune Checkpoint Inhibitors (Anti-PD-1, -PD-L1, and -CTLA4 Therapies). Risk C: Monitor therapy

Khat: May decrease the serum concentration of Amoxicillin. Management: Consider administering amoxicillin before, or 2 hours after, khat chewing to avoid reductions in amoxicillin bioavailability. Risk D: Consider therapy modification

Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol. Risk C: Monitor therapy

Methotrexate: Penicillins may increase the serum concentration of Methotrexate. Risk C: Monitor therapy

Mycophenolate: Penicillins may decrease serum concentrations of the active metabolite(s) of Mycophenolate. This effect appears to be the result of impaired enterohepatic recirculation. Risk C: Monitor therapy

Probenecid: May increase the serum concentration of Betalactamase Inhibitors. Management: Coadministration of probenecid with amoxicillin/clavulanate is not recommended per official package labeling. Risk D: Consider therapy modification

Sodium Benzoate: Penicillins may diminish the therapeutic effect of Sodium Benzoate. Risk C: Monitor therapy

Sodium Picosulfate: Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Risk D: Consider therapy modification

Tetracyclines: May diminish the therapeutic effect of Penicillins. Risk C: Monitor therapy

Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Avoid use of live attenuated typhoid vaccine (Ty21a) in patients being treated with systemic antibacterial agents. Postpone vaccination until 3 days after cessation of antibiotics and avoid starting antibiotics within 3 days of last vaccine dose. Risk D: Consider therapy modification

Vitamin K Antagonists (eg, warfarin): Penicillins may enhance the anticoagulant effect of Vitamin K Antagonists. Risk C: Monitor therapy

Dietary Considerations

May be taken with meals or on an empty stomach; take with meals to increase absorption and decrease GI upset; may mix with milk, formula, or juice. Extended release tablets should be taken with food. Some products may contain sodium. Some products contain phenylalanine. All dosage forms contain potassium.

Pregnancy Considerations

Both amoxicillin and clavulanic acid cross the placenta (Muller 2009; Weber 1984). An increased risk of necrotizing enterocolitis in neonates or bowel disorders in children may be associated with amoxicillin/clavulanate when exposure occurs near delivery (Kenyon 2001).

Oral ampicillin-class antibiotics are poorly absorbed during labor. Clavulanate does not appear to influence maternal amoxicillin pharmacokinetics following IV administration of amoxicillin/clavulanate prior to delivery (Muller 2009).

As a class, penicillin antibiotics are widely used in pregnant women. Based on available data, penicillin antibiotics are generally considered compatible for use during pregnancy (Ailes 2016; Bookstaver 2015; Crider 2009; Damkier 2019; Lamont 2014; Muanda 2017a; Muanda 2017b).

Untreated urinary tract infections (UTI) during pregnancy are associated with an increased risk of developing pyelonephritis, low birth weight, and preterm labor. Amoxicillin/clavulanate may be an option for the treatment of UTI during pregnancy (Betschart 2020; de Rossi 2020; IDSA [Nicolle 2019]; Usta 2011).

Antibiotics are used in the management of preterm prelabor rupture of membranes (PROM) to prolong pregnancy and reduce the risk of infection. However, due to the possible increased risk of necrotizing enterocolitis, amoxicillin/clavulanate is not recommended for this indication (ACOG 217 2020).

Amoxicillin/clavulanate is considered compatible for the of treatment airway diseases in pregnant women. Use should be avoided in women at risk for preterm delivery (due to association with necrotizing enterocolitis) (ERS/TSANZ [Middleton 2020]).

The routine use of antibiotics prior to an operative vaginal delivery (vacuum or forceps delivery) is not currently recommended. However, amoxicillin/clavulanate IV administered after an operative vaginal delivery may decrease the risk of a maternal infection occurring within 6 weeks postpartum. A single dose may be appropriate in specific cases (Knight 2019; Liabsuetrakul 2020).

Monitoring Parameters

With prolonged therapy, monitor renal, hepatic, and hematologic function; monitor for signs of hypersensitivity, including anaphylaxis.

Mechanism of Action

Clavulanic acid binds and inhibits beta-lactamases that inactivate amoxicillin resulting in amoxicillin having an expanded spectrum of activity. Amoxicillin inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Pharmacokinetics (Adult Data Unless Noted)

Amoxicillin pharmacokinetics are not affected by clavulanic acid.

Amoxicillin: See individual Amoxicillin monograph.

Clavulanic acid:

Distribution:

Vd: Children ≥2 years and Adolescents ≤14 years: 0.368 ± 0.014 L/kg (Schaad 1983).

Protein binding: ~25%.

Half-life elimination:

Oral:

Infants ≥8 months and Children <12 years: 1.1 ± 0.3 hours.

Adults: 1 hour.

IV:

Children ≥2 years and Adolescents ≤14 years: 0.81 ± 0.04 hours (Schaad 1983).

Time to peak: Oral:

Infants ≥8 months and Children <12 years: Median: 1.1 hours; range: 1 to 4 hours.

Adults: 1.5 hours.

Excretion: Urine (25% to 40% as unchanged drug).

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Anti-infective considerations:

Parameters associated with efficacy:

Amoxicillin: Refer to Amoxicillin monograph.

Clavulanate (in combination with amoxicillin): Not defined.

Expected drug exposure in normal renal function:

Pediatric patients, Cmax (peak):

Oral suspension (4:1 ratio); single dose:

Children 2 to 5 years of age: Amoxicillin 125 mg/clavulanate 31.25 mg per 5 mL: Mean dose amoxicillin 9.11 ± 1.83 mg/kg: Amoxicillin 3.45 ± 1.14 mg/L; clavulanate: 1.18 ± 0.63 mg/L (van Niekerk 1985).

Children 6 to 10 years of age: Amoxicillin 250 mg/clavulanate 62.5 mg per 5 mL: Mean dose amoxicillin 12.35 ± 3.11 mg/kg: Amoxicillin: 4 ± 1.65 mg/L; clavulanate: 1.31 ± 0.79 mg/L (van Niekerk 1985).

Oral suspension (14:1 ratio), amoxicillin 600 mg/clavulanate 42.9 mg per 5 mL; steady state:

Infants ≥8 months of age and children ≤11 years of age: Amoxicillin 45 mg/kg/dose every 12 hours: Amoxicillin: 15.7 ± 7.7 mg/L; clavulanate: 1.7 ± 0.9 mg/L.

Oral tablet, extended release; steady state:

Children ≥7 years of age and adolescents ≤15 years of age (weighing ≥40 kg): Amoxicillin 2,000 mg/clavulanate 125 mg every 12 hours: Amoxicillin: 11 ± 3.34 mg/L; clavulanate: 1.17 ± 0.67 mg/L.

IV (5:1 ratio) [Canadian product]; single dose, 2-minute infusion:

Children ≥2 years of age and adolescents ≤14 years of age: Amoxicillin 25 mg/kg/dose: Amoxicillin: 89.4 mg/L; clavulanate: 19.5 mg/L (Schaad 1983).

Adults, Cmax (peak):

Oral tablet; steady state:

Amoxicillin 250 mg/clavulanate 125 mg every 8 hours: Amoxicillin: 3.3 ± 1.12 mg/L; clavulanate: 1.5 ± 0.7 mg/L.

Amoxicillin 500 mg/clavulanate 125 mg every 12 hours: Amoxicillin: 6.5 ± 1.41 mg/L; clavulanate: 1.8 ± 0.61 mg/L.

Amoxicillin 500 mg/clavulanate 125 mg every 8 hours: Amoxicillin: 7.2 ± 2.26 mg/L; clavulanate: 2.4 ± 0.83 mg/L.

Amoxicillin 875 mg/clavulanate 125 mg every 12 hours: Amoxicillin: 11.6 ± 2.78 mg/L; clavulanate: 2.2 ± 0.99 mg/L.

Oral tablet, chewable; single dose:

Amoxicillin 250 mg/clavulanate 62.5 mg: Amoxicillin: 6.9 mg/L; clavulanate: 1.6 mg/L.

Amoxicillin 400 mg/clavulanate 57 mg: Amoxicillin: 6.67 ± 1.37 mg/L; clavulanate: 1.03 ± 0.33 mg/L.

Oral tablet, extended release; single dose:

Amoxicillin 2 g/clavulanate 125 mg: Amoxicillin: 17 ± 4 mg/L; clavulanate: 2.05 ± 0.8 mg/L.

IV [Canadian product]; single dose:

Amoxicillin 500 mg/clavulanate 100 mg, bolus: Amoxicillin: 32.2 mg/L; clavulanate: 10.5 mg/L.

Amoxicillin 1 g/clavulanate 200 mg, bolus: Amoxicillin: 105.4 mg/L; clavulanate: 28.5 mg/L.

Amoxicillin 2 g/clavulanate 200 mg, 30-minute infusion: Amoxicillin: 108 mg/L; clavulanate: 13.9 mg/L.

Postantibiotic effect:

H. influenzae: 0 to <2 hours; S. pneumoniae: 0 to <3 hours; Streptococcus pyogenes: 0 to 3.9 hours; methicillin-susceptible S. aureus: 0 to 2.55 hours; Enterobacterales: 0 to <1 hour (Dubois 2000; Neuhauser 2001; Thorburn 1996).

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Amoclan | Amoxidin Plus | Augmatic | Augmentin | Clamox | Clavam | Clavodar | Curam | Dioclav | Enhancin | Gloclav | Julmentin | Julmentin 2x | Klavox | Medaclav | Megamox | Moxclav | Neoclav;
  • (AR) Argentina: Aclav | Amoclav duo | Amoclav se | Amoxi Plus | Amoxicilina-clavulanico | Amoxifarma duo | Amoxigrand compuesto | Amoxitenk plus | Bi moxal | Bi moxal duo | Bioclavid | Bioxilina plus | Bioxilina Plus Duo | Clamoxol Duo | Clavulox | Clavulox Duo | Cloximar duo | Dibional | Fabamox duo | Fullcilina plus | Grinsil clavulanico | Klonalmox | Nobactam clavulanico | Nobactam clavulanico 2 | Omnigal | Omnigal s | Optamox | Plenobiotic duo | Tibimox clavulanico | Tibimox clavulanico duo | Ultrabiotic | Ultrabiotic Duo;
  • (AT) Austria: Amoclan | Amoclanhexal | Amoxicil/clavulansaeure krka | Amoxicillin/clavulansaeure a-med | Amoxicillin/clavulansaeure actavis | Amoxicillin/Clavulansaeure AptaPharma | Amoxiclavulan 1a pharma | Amoxicomp | Amoxiplus | Amoxistad plus | Augmentin | Augmentin Duo | Clavamox | Clavamox duo | Curam | Xiclav;
  • (AU) Australia: Alphaclav duo | Alphaclav duo forte | AMCLAVOX DUO | Amclavox Duo forte | Amoxicillin clavulanic acid | Amoxiclav juno | Amoxycillin/Clavulanic Acid Generic Health | Amoxyclav rbx | Apo Amoxi Clav | Apo amoxycillin and Clavulanic Acid | Apx amoxicillin/clavulanic acid | Augmentin | Augmentin Duo | Augmentin duo forte | Ausclav | Clamohexal | Clamohexal duo | Clamoxyl | Clavulin | Clavulin duo | Clavycillin | Cm amoxycil clavul | Curam | Curam duo | Ga amclav | Genrx amoxy clavul | Moxiclav duo | Pharmacor amoxyclav | Tw amoxycil clavul;
  • (BD) Bangladesh: Amoclav | Amoksiklav | Augment | Augmentin | Avloclav | Clamox | Demoxiclave forte | Demoxil Plus | Fimoxyclav | Moxaclav | Tyclav | Ultraclav;
  • (BE) Belgium: Amoclane eg | Amoclane eurogenerics | Amoxicillin/clavulanic acid ab | Amoxiclav | Amoxiclav Mylan | Amoxiclav Sandoz | Amoxiclav Teva | Augmentin | Bioclavid | Clavucid | Clavulics | Co amoxi | Docamoclaf;
  • (BF) Burkina Faso: Alvonal | Augmacillin | Augmentin | Bactoclav | Beclav | Clavam | Clavicin | Clavicin xr | Clavuject | Clavumoccid | Cledomox | Coamox | Curam | Enhancin | Fleming | Imuclav | Klacin | Synclav | Umeclav | Xeclav | Zamox;
  • (BG) Bulgaria: Almexid | Alvoclav | Amoksiklav | Amoksiklav es | Amoxigamma | Amoxigard | Augmentin | Betaclava | Betaklav | Climox | Curam | Enhancin | Medoclav | Medoclav bis | Medoclav forte | Moxiclav | Neoamoclav | Penlac;
  • (BR) Brazil: Aclaf | Amoxicilina + clavul potassio | Amoxicilina + clavulanato de potassio | Amoxicilina + clavulanato potassico | Amoxicilina clavulanato de potassio | Amplamox AC | Atak clav | Betaclav bd | Clavicin | Clavoxil | Clavulin | Clavulin bd | Clavulin es | Clavutrex | Claxam | Doclaxin | Emyclam | Lanico | Novamox | Policlavumoxil | Policlavumoxil bd | Sigma clav bd | Sinot Clav | Uciclav;
  • (CH) Switzerland: Amicosol | Augmentin | Augmentin Duo | Aziclav | Aziclav duo | Clavamox | Clavu-basan | Co amoxi | Co amoxi mepha | Co Amoxicillin | Co amoxicillin devatis | Co amoxicillin spirig hc | Co amoxicillin zentiva;
  • (CI) Côte d'Ivoire: Aclav | Amfocin | Amoclan | Amoclan forte | Amoxiclav denk | Augmentin | Beclav | Biotic plus enfant | Clavam | Clavicin xr | Clavoxi care | Clavu nova | Clavuxin | Clavuxin enfant | Clavuxin nourrisson | Claxi | Cledomox | Co amoxiclav sp | Curam | Imuclav | Imuclav duo | Imuclav ultra | Klamoks | Maxiclav | Mediclav | Novaclav | Saphir | Soclav | Theoclav | Traclav | Umeclav | Vaamox | Zamox | Zanitin duo;
  • (CL) Chile: Ambilan | Ambilan bid | Amolex | Amolex duo | Amoxiclav | Augmentin | Augmentin BID | Bioclavid | Clavam duo | Clavinex | Clavinex duo | Clavoxilina bid | Clavulin | Maximox | Moxivulan | Vulamox | Zolimax duo;
  • (CN) China: Alker | Amoclar | Amoksiklav | Amoxicillin and Clavula. Potassium | Amoxicillin and clavulanate potassiu. | Amoxicillin and clavulanate potassium | Amoxicillin and clavulanate potassium (14:1) | Amoxicillin and clavulanate potassium chewable tablets (8:1) | Amoxicillin and clavulanate potassium dispersible tablets (4:1) | Amoxicillin and clavulanate potassium dispersible tablets(14:1) | Amoxicillin sodium and clavulanate potassium | Amoxycillin | An mie jun | An qi | An sa lin | Anke | Ao ge men ting | Ao xian | Augmentin | Bang lin | Bi qi er | Cheng xi kai | Chong mei | Co-amoxiclav | Curam | Feng ke lin | Fu rui bo kang | Hai ke la | Hyphidga | Jian ao | Jida a bang | Jin li shu | Jun er qing | Li ding sha | Nuo ke | Qiang li a mo xian | Qing ke lin | Rui si | Seger | Sheng ai | Shi di xin | Shu xian lin | Wei Li Jia | You lin jia | You neng | Yuan xin | Zhong nuo ke lin | Zu neng;
  • (CO) Colombia: Acix | Amoxclaver | AMOXICILINA + ACIDO CLAVULANICO | Amoxicilina + clavulanato de potasio | Amoxicilina acido clavulanico vitalis | Amoxicillina/Acido clavulanico | Amoxicladelt | Amoxiclin | Amoxiclin duo | Amoxiclin duo ninos | Amoxidal plus | Atak clav | Biomicilina | Clamicil bid | Clavulin | Curam | Curam junior | Ipiclav | Koact | Nirmox cl | Obnarin | Sumivulin | Vulamox;
  • (CZ) Czech Republic: Afreloxa | Amoksiklav | Amoxicillin/clavulanic acid aurovitas | Amoxicillin/clavulanic acid dr.max | Amoxicillin/clavulanic acid mylan | Amoxicillin/clavulanic aptapharma | Amoxicillin/clavulanic olikla | Augmentin | Betaklav | Curam | Enhancin | Medoclav | Megamox | Penlac;
  • (DE) Germany: Amoclanhexal | Amoclav | Amoxclav | Amoxclav hexal | Amoxi clavulan Al | Amoxi clavulan puren | Amoxi saar plus | Amoxi-clavulan | Amoxicillin comp | Amoxicillin comp. | Amoxicillin plus | Amoxicillin Ratiopharm comp | Amoxicillin/clavulanic acid micro labs | Amoxicillin/clavulansaeure al | Amoxicillin/clavulansaeure devatis | Amoxicillin/Clavulansaeure Heumann | Amoxicillin/Clavulansaeure Micro Labs | Amoxicillin/clavulansaeure zentiva | Amoxicillin/Clavulansaure AAA Pharma | Amoxiclav | Amoxiclav alkem | Amoxiclav aristo | Amoxiclav ct | Amoxiclav Fair Med | Amoxiclav hikma | Amoxiclav ibisqus | Amoxidura plus | Amoxillat clav | Amoxiplus comp | Augmentan | Augmentin | Augmentine | Bioclavid | Co amoxiclav | Infectosupramox;
  • (DO) Dominican Republic: Acimox ac | Amator 1000 | AMOXICILINA + ACIDO CLAVULANICO | Amoxicilina acido clavulanico calox | Amoxicilina y clavulanato potasico | Apo Amoxi Clav | Augmentin | Bactoclav | Clamicil | Clavam | Clavinex duo | Clavoxilina bid | Clavucyd bid | Clavulin | Cluvoxin | Curam | Duo amox | Enhancin | Fulgram | Kanex | Laprimox clav | Mediclav | Mopen plus | Moxil duo aglf | Noprilam | Rovulanato A | Suclav | Sumox ac;
  • (EC) Ecuador: Amocla | Amolex Bid | Amolex Uf | Amoxicilina + ac.clavulanico | Amoxicilina + acido clavulanico | Amoxidin cl | Augmentin | Augmentin bd | Augmentin es | Clavinex | Clavinex duo | Clavoxine | Clavucid | Clavunix | Clavurol | Clavutam | Curam | Edvabac | Edvabac acino | Enhancin | Fabamox duo | Oxialvulam | Reproxil | Sinergia | Vulamox;
  • (EE) Estonia: Amclav | Amoclav 500 plus | Amoksiklav | Amoksiklav 2x | Amoxicillin/clavulanic acid | Amoxicillin/clavulanic acid actavis | Amoxiklav | Augmentin | Betaklav | Curam | Medoclav | Moxiclav | Moxiline;
  • (EG) Egypt: Amoclawin | Augmacillin | Augmentin | Averobios | Bioclavox | Clavimox | Clavocillin | Clavosigma | Clavucin | Curam | Curiclav | Deltaclav | E moxclav | Gardinova | Hibiotic | Hibiotic n | Julmentin | Klavox | Maclavex | Magna biotic | Megamox | New Clav;
  • (ES) Spain: Amoxicilina + Acido Clavula. Sandoz | Amoxicilina + Acido Clavulanico Alter | Amoxicilina + Acido Clavulanico Combino Pharm | Amoxicilina + Acido Clavulanico Genericos Juv | Amoxicilina + Acido Clavulanico Mundogen | Amoxicilina + Acido Clavulanico Normon | Amoxicilina /Acido clavulanico Mundogen | Amoxicilina /acido clavulanico pensa | Amoxicilina acido clavulanico sala | Amoxicilina clav | Amoxicilina+Acido Clavul.Ratiopharm | Amoxicilina/acido clavulanico almus | Amoxicilina/Acido clavulanico Alter | Amoxicilina/acido clavulanico ardineclav | Amoxicilina/acido clavulanico aurobindo | Amoxicilina/Acido clavulanico Cinfa | Amoxicilina/acido clavulanico Combix | Amoxicilina/acido clavulanico dermogen | Amoxicilina/Acido Clavulanico Frous | Amoxicilina/Acido clavulanico Generis | Amoxicilina/Acido clavulanico IPS | Amoxicilina/acido clavulanico kern pharma | Amoxicilina/acido clavulanico mundogen | Amoxicilina/acido clavulanico pensa | Amoxicilina/acido clavulanico sandoz | Amoxicilina/acido clavulanico tad | Amoxicilina/acido clavulanico tarbis | Amoxicilina/Acido clavulanico UR | Amoxicillin/clavulanic acid | Amoxicillin/clavulanic acid tecnigen | Amoxicillina/Clavulanico Normon | Amoxilina/Acido Clavulanico Mayne | Amoxyplus | Ardineclav | Augmentine | Clavucid | Clavumox | Duonasa | Eupeclanic | Kelsopen | Medoclav;
  • (ET) Ethiopia: Acinet | Amoxicillin + clavulanic acid | Amoxicillin and clavulanate potassium | Amoxicillin and clavulanate potassium ER | Amoxicillin and potassium clavulanate | Amoxicillin sodium and clavulanate potassium | Amoxiclav denk | Augmentin | Augmentin es | Bactoclav | Clavamyn | Clavomid | Co-amoxiclav | E moxclav | Enhancin | Indclav | Injmentin | Julmentin | Julmentin 2x | Klamoks bid | Magna biotic | Medoclav | Moxipil cv | Myclav | Neoclav | Syntoclav | Syntoclav forte;
  • (FI) Finland: Amorion comp | Amoxicillin/clavulanic acid aurobindo | Amoxin comp | Augmentin | Betaklav | Bioclavid | Clapharin comp | Clavurion | Clavuxal | Spektramox;
  • (FR) France: Amoxicilline/Acide Clavulaniq. Arrow | Amoxicilline/Acide Clavulaniq. G Gam | Amoxicilline/Acide Clavulaniq. Sandoz | Amoxicilline/Acide Clavulaniq. Teva | Amoxicilline/Acide Clavulanique | Amoxicilline/acide clavulanique alter | Amoxicilline/Acide Clavulanique Biogaran | Amoxicilline/Acide Clavulanique EG | Amoxicilline/Acide Clavulanique Merck | Amoxicilline/acide clavulanique Panpharma | Amoxicilline/Acide Clavulanique Qualimed | Amoxicilline/Acide Clavulanique Ranbaxy | Amoxicilline/Acide Clavulanique RPG | Amoxicilline/acide clavulanique sandoz | Amoxicilline/acide clavulanique Zydus | Augmentin | Ciblor | Levmentin;
  • (GB) United Kingdom: Amoclan | Augmentin | Co amoxiclav | Co amoxiclav arrow | Co amoxiclav cox | Co-amoxiclav | Ranclav;
  • (GH) Ghana: Amoksiklav | Bimox | Clavu nova | Exoclav | Ipiclav 625 | Lyclav | Rox clav;
  • (GR) Greece: Accordia | Amoxicillin clavulanic acid kabi | Augmentin | Bioclavid | Co Amoxiclav/Mylan | Frolicin | Fugentin | Moxiclav | Taromentin;
  • (HK) Hong Kong: Amoksiklav | Augmentin | Clamovid | Clanoxy | Clavomid | Cledomox | Co amoxiclav | Co-amoxiclave | Curam | Fleming | Lidingsha | Moxiclav | Quali mentin;
  • (HN) Honduras: Etimox duo;
  • (HR) Croatia: Amoksiklav bid | Augmentin | Betaklav | Clavius | Klavax bid | Klavobel | Klavobel BID | Klavocin | Klavocin bid | KlavoPhar | Medoclav;
  • (HU) Hungary: Aksolin | Aktil | Almowill duo | Amoclan | Amoksiklav | Amoxicillin/klavulansav aptapharma | Amoxicillin/klavulansav aurobindo | Amoxicillin/Klavulansav Mylan | Amoxilan duo | Amoxiplus | Augmentin | Augmentin biogal | Axocil duo | Betaklav | Clavumox | Curam | Enhancin | Oxamoran | Xivulan | Xylenn;
  • (ID) Indonesia: Aclam | Amocomb | Ancla | Augmentin | Auspilic | Bellamox | Betaclav | Biditin | Capsinat | Clabat | Clacomb | Clamixin | Clamobit | Claneksi | Clavamox | Claxy | Co amoxiclav | Co-amoxiclav | Co-amoxiclave | Comsikla | Danoclav | Daxet | Dexyclav | Duazat | Erabam | Hexaclav | Ikamoxyl Plus | Improvox | Inciclav | Lansiclav | Miraclav | Nufaclav | Nuvoclav | Palentin | Prafamoc | Protamox | Surpas | Syneclav | Viaclav | Viaclav Vial | Vibranat | Vulamox | Xiclav | Zumafen;
  • (IE) Ireland: Amoclav | AMOXICILIN/CLAVULANIC ACID KRKA | Augmentin | Augmentin Duo | Augmentin-duo | Bellmentin | Clavamel | Co amoxiclav | Co amoxiclav bluefish | Co amoxiclav sugar free | Co amoxiclav teva | Germentin | Pinaclav;
  • (IL) Israel: Amoxiclav Teva | Augmentin | Clavamox | Claventin;
  • (IN) India: Ab cv | Abclox CV | Ac 2 | Aceclave | Aclav | Actis | Acuclav | Adclav | Admoxy cv | Admoxy duo | Adpax | Advent | Aequimentin | Allmox-c | Almox cv | Amclaid | Amclocent | Amclue | Amgat | Amkev | Amoclave | Amoclax | Amokav | Amolin cv | Amonic | Amotex ag | Amotid clav | Amoxicillin and clavulanate potassium | Amoxidol | Amoxise cv | Amoxyclav | Amoxyjet cv | Ampilox cv | Ampoxin cv | Anticlav | Apcil | Aroclav | Auclan | Audiclav | Augduo | Augmentin | Augmexx | Augmox | Augnet | Augpen | Augremo | Augutroy | Augvo cv | Augwel | Aulanic | Ausmoclav | Axlam cv | Axn cv | Azamox cv | Bacimox cv | Bactoclav | Bactoclav es | Bactovan | Barclav | Barrister | Baxiclav | Benzoclav | Bestomax | Biclopen cv | Bilclav | Bilin plus | Bioclavid | Blumox-ca | Boostim | Boxyclav | Bruclav | C Mox | Caremox ag | Caremox ag 625 | Carolox cv | Cavmox | Cipclav | Cipmox cv | Clafect duo 625 | Clafel | Clamchek | Clamoff 375 | Clamox | Clamoxin | Clamp | Clanic | Clanoxy | Clarence | Clauvmentin | Clavace | Clavactum | Clavam | Clavam es | Clavax | Clavcare | Clavcare w | Clavcure | Clavek c | Clavid a | Clavid a 1000 | Clavidur | Clavifast | Clavimox | Clavit | Clavituf | Clavmark | Clavmentin | Clavmox | Clavobid | Clavosis | Clavotec | Clavotrol | Clavox | Clavoxone | Clavris c | Clavu m | Clavubit | Clavx | Clawin | Clazimox | Clearmox cv | Cledomox | Clevermox | Clompic cv | Clovista | Co cv | Coeamox 625 | Cosymoxyl | Curam | Delpoclav | Demoxin CV | Demoxin cv | Doiss | Doo clav | Dosclav | Duciclav | Duclav | Duet | Duomox | Duomox 625 | Duroclav | Ecomox cv | Enclav | Enclave | Enhancin | Eradiclav Duo | Erox CV | Estamox cv | Exario | Fection dd | Fection ds | Femexel | Figthox | Finemox cv | Finemox cv xr | Flamclov | Flemiclav | Fortclav | Gericlav | Gl 625 | Glanclav | Glyph cv | Godclav | Goldclav | Grandmox | Hhamclav | Hibrid | Ibiclav | Ibimox | Ibimox bd | Icpamox cv | Inclab 625 | Inclab dry syrup | Indclav | Iphaclav | Jonclav cv | Joyclav | Kastle | Kaymoxmentin | Kaziclav | Kilban | Klavocillin | Klclav | Koact | Konamox cv | Konqur | Kusamox | Kwikmox cv | Laciclav | Lacom cv | Lactoclaav | Lariclav | Larimox | Larimox 625 duo | Lymoxil cv | Magcil cv | Masterclav | Maxigem | Maximizin | Medimox cv | Medmox cv | Mega CV | Megaclav | Megamentin | Megamox CV | Meroxin | Miximox cv | Moclawin | Monamox cl | Monoclav | Mordica | Mox cv | Moxbio cv | Moxbro CV | Moxclav | Moxibond | Moxicom CV | Moxidas cv | Moxiease cv | Moxiforce cv | Moxigem | Moxikare | Moxikind cv | Moxileb cv | Moxilink c | Moxipic cv | Moxiplus cv | Moxivib cv | Moxiwiz cv | Moxlox CV | Moxmentin | Moxnecs clav | Moxodin cv | Moxreme cv | Moxxil duo | Moxxil Kid | Moxyclav | Moxylite cv | Moxynic | Moxyzen clav | Mpox CV | Mpx cv | Mucoclav | Multiclav | Mxson cv | Myclav | New numox | Nikomox-cv | Nova cv | Novaclav | Novamentin | Novamox CV | Nuclav | Oc clav | Octamox cv | Ogmen | Ogmios | Omniclav | Onamox Cl | One clav | Optimox cv | Pactel | Pd Mox C | Pedi ag | Penclav | Penhance | Penlactic | Pentamentin | Pexoclav | Polyclav | Powerclav | Pranmox cv | Pressclav | Princiclav | Proclav | Radimentin | Radimox cv | Rapiclav | Regs ac | Remiclav | Resiclav | Roclav | Roclav bd | Romox cl | Romox cv | Ronclav | Ronclav ds | Rozeclav | Rti Clav | Sagumin | Saimox CV | Samclav | Semox cv | Sensiclav | Septoclav | Sporiclav | Staclav | Sunclav | Surmox CV | Swiftclav | Symbiotik xl | Symbiotik-xl | Synclav | Tegamox Plus | Tervis | Themiclav ds | Threoclav | Tilmox cv | Topclav | Tormoxin clav | Tormoxin Clav | Toxo mox | Tresmox cv | Troclav | Truclave | Twinox | Ulticlav | Ultimox | Verclav | Vivobact | Vomox cv | Vulacin | Warclav | Wideclav | Xoclave | Xpand | Xtraclav | Xyclav | Xylomox cv | Yesmox CL | Zovax cv | Zoxil-CV | Zubact | Zyclav;
  • (IQ) Iraq: Aumentin mdi | Moxclav;
  • (IT) Italy: Abba | Abioclav | Acadimox | Amocla | Amox+ac clav Acv | Amox+ac clav Alm | Amox+Ac Clav alter | Amox+Ac Clav Doc | Amox+Ac Clav EG | Amox+ac clav IBI | Amox+Ac Clav Mgi | Amox+ac clav ranb | Amox+ac clav ratio | Amox+Ac Clav San | Amox+ac clav San | Amox+Ac Clav Wip | Amox+ac clavul abc | Amoxic.ac.clavul. | Amoxicillina e acido clavulanico angenerico | Amoxicillina e acido clavulanico aurobindo | Amoxicillina e acido clavulanico bluefish | Amoxicillina e acido clavulanico eurogenerici | Amoxicillina e acido clavulanico Krka | Amoxicillina e acido clavulanico pfizer | Amoxicillina e acido clavulanico ratiopharm | Amoxicillina e acido clavulanico zentiva | Amoxicillina/Acido clavulanico | Anival | Augmentin | Augmentin bambini | Aveggio | Clautero | Clavomed | Clavulin | Euticlavir | Homer | Kruxade | Mondex | Moxivul | Neo Duplamox | Neoduplamox bambini | Posmox | Puriclav | Saromox | Stemox | Xinamod;
  • (JO) Jordan: Amoclan | Augmentin | Auxlav | Clamoxin | Clavar | Clavodar | Curam | Gloclav | Julmentin | Julmentin 2x | Klamoks | Klavox | Megamox | Moxiclav | Ramoclav;
  • (JP) Japan: Augmentin | Augmentin combination;
  • (KE) Kenya: Acinet | Amciclav | Amclamed | Amocin cla | Amoclan | Amoclan bid | Amoklavin | Amoxicillin and potassium clavulanate | Amoxiclav denk | Augmentin | Augmentin bd | Augmentin es | Augmin | Augpen | Augyclav | Bactoclav | Bactoclav 1000 | Bactoclav 375 | Bactoclav 625 | Bactrid ee | Beeclav | Cerobact | Cinclav | Cipclav | Clamoxin | Claneksi | Claneksi forte | Clanoxy | Clauviax | Clav | Clavall | Clavam | Clavam bid | Clavam forte | Clavamyn | Clavcon | Clavicin | Clavimox | Clavmark | Clavodar | Clavomid | Clavulin | Claxy | Cledomox | Coamox | Coamox acino | Corclav | Cosil | Curam | Dafraclav | Dioclav | Dumoclav | Emoxclav | Enhancin | Famoxiclav | Finemox cv | Fleming | Gamok | Hibiotic | Indclav | Injmentin | Julmentin | Julmentin 2x | Julmentin forte | Kamox clav | Klavmox | Koact | Labclav | Moxaclav | Moxiforce cv | Moxikind cv | Myclav | Neoclav | Novaclav | Numolav | Rapiclav | Redamox | Vemoxin cv | Winclav | Yumox cl | Zyclave;
  • (KR) Korea, Republic of: A clan | A clan duo | A clan neo | A cran | Acicla | Acicla duo | Acicla neo | Acla | Acla Duo | Acla neo | Aclan | Aclan duo | Aclantis | Aclantis duo | Aclao | Aclaon duo | Aclas | Acrentin duo | Acrentine | Acrentine duo | Ahacool | Ahacool duo | Aicillin duo | Aicillin s | Aircla duo | Amiclan | Amiclan Duo | Amocicle | Amocicle duo | Amocla | Amocla duo | Amocla neo | Amoclan | Amoclan duo | Amoclzen duo | Amocombi duo | Amocrin | Amoctasim | Amoctasim duo | Amoctasim neo | Amoctaxim | Amoctin | Amoctin duo | Amokcla | Amokcle | Amokcle duo | Amolanic | Amolanic duo | Amolanic es | Amomentin | Amoracillin | Amorex | Amorex duo | Amorex neo | Amosidal | Amosidal duo | Amov | Amovedy | Amoxa | Amoxa duo | Amoxalin | Amoxalin duo | Amoxalin neo | Amoxan duo | Amoxcl | Amoxcla | Amoxclan duo | Amoxclan neo | Amoxic | Amoxicla | Amoxicle | Amoxitin | Amoxitin duo | Amoxiyeon duo | Amoxklin duo | Amoxtacim neo | Anticlan | Anycla | Anycra | Anycra duo | Anycra neo | Auclan | Auclatin | Auclatin duo | Auclatin neo | Aucmectin | Augmac | Augmac duo | Augme | Augme duo | Augme neo | Augmen | Augmen duo | Augmentam | Augmenti s | Augmentin | Augmentin Duo | Augmex | Augmex duo | Augmex neo | Augtin | Augtin duo | Augtinneo | Augucillin | Augucillin duo | Augucla | Augumac | Augumac duo | Augutin | Augutin duo | Aumentin | Aumentin duo | Aumetin | Beacla | Bearcla | Bearcla duo | Bi cla duo | Bi cla neo | Bicla | Camodix | Camodix duo | Cj amocombi duo | Clabulo duo | Clacillin | Clacillin duo | Clacillin neo | Cladus | Clamax | Clamax duo | Clamax neo | Clamentin | Clamentin duo | Clamo | Clamo duo | Clamonex | Clamonex duo | Clamonexpotin | Clamox | Clamox duo | Clamox neo | Clamoxen | Clamoxen duo | Clamoxen neo | Clamoxil | Clamoxil duo | Clamoxin | Clamoxin duo | Clamoxin neo | Claoxin | Claoxin duo | Clarin duo | Clarin neo | Clarinneo | Classirine neo | Clavutin | Clavutin duo | Clavutine | Clavutine duo | Cloanan duo | Cloanan neo | Clumox duo | Cracizen duo | Cramax neo | Cramon | Cramon duo | Cramon neo | Cramotin | Cramotin duo | Cramoxin Duo | Crasigen | Croanan | Croanan dou | Croanan duo | Croanan neo | Curamus | Curamus duo | Ducla | Ducla duo | Duocla | Duocla neo | Duonex | Glocilin | Glocillin duo | Gumentin | Gumentin neo | Hucla | Huniz claduo | Huons amoxicla | Hwamocle | Hycla | Hycra | Hycra duo | Hycra neo | Hycraduo | Icillin | Icillin duo | Icillin s | Inist neo | Inxiclan | Inxiclan neo | K mentin duo | K mentine | K-cillin | Klavon | Klavon duo | Klavon neo | Kmoxilin | Kmoxilin 7/1 | Lactamox | Lactamox duo | Lactamox neo | Lamocla duo | Lamocrin | Lamocrin duo | Lamocrin neo | Lamoxilin | Liumox | Martin | Maxcillin | Maxcillin duo | Maxiclan | Maxiclan duo | Maxiclan neo | Maxicran duo | Maxilin | Maxilin duo | Medicla | Medicla duo | Moxamentin | Moxamentin Duo | Moxamentin neo | Moxicla | Moxiclan | Moxiclan duo | Moxicle | Moxicle duo | Moxicle neo | Moxiclen | Moxicra | Moxivl duo | Moxivl neo | Myungmoon amoclan | Myungmoon amoclan duo | Nanocra | Necmoclean | Necmoclean duo | Necmoclean neo | Neocla duo | Newcla | Newmokcra | Novoclan | Novoclan duo | O men | O men duo | Oclan duo | Oclan neo | Ocratin | Omecla | Omecla duo | Omecle | Omecle neo | Ometin | Ometin duo | Pamockle | Pamockle duo | Pencla | Pencra | Pencra duo | Penimentin | Pleming | Potacin | Potacin duo | Potacin neo | Priclan | Richmentin | Samjungtin | Tiramox | Tiramox s | Unicra | Yucla | Yucla duo | Yuhan amoxicillin clavulanate | Yuromentin | Yuromentin duo | Zakutex | Zakutex duo | Zakutex neo;
  • (KW) Kuwait: Amoclan | Augmentin | Clavamox | Clavodar | Clavomox | Coamox | Curam | Gloclav | Hibiotic | Julmentin | Julmentin 2x | Klavox | Neoclav;
  • (LB) Lebanon: Amoclan | Amoclan bid | Amoklavin | Amoklavin bid | Ardineclav | Augmacillin | Augmentin | Betamox | Calamox | Clavodar | Clavomid | Coamox | Curam | E moxclav | Enhancin | Fleming | Fugentin | Gloclav | Homer | Julmentin | Klavox | Klavunat bid | Klavunat es | Megamox | Moxiclav | Moxiclav bis | Moxiclav forte | Ogmentinine | Panklav | Panklav Forte;
  • (LT) Lithuania: Amoksiklav | Amoksiklav 2x | Amoxicillin/clavulanic acid actavis | Amoxicillin/Clavulanic acid Siromed | Aniclav | Apomox | Augmentin | Augmentin DDS | Augmentin Duo | Augmentin es | Betaklav | Clavam xr | Curam | Elmox cv | Enhacin | Formox cv | John clav | Klavocin | Medoclav | Moxiclav;
  • (LU) Luxembourg: Amoclane eg | Amoxiclav | Amoxiclav Sandoz | Augmentin | Clavucid | Docamoclaf;
  • (LV) Latvia: Amoksiklav | Amoksiklav 2x | Amoxicillin/clavulanic acid aurobindo | Augmentin | Augmentin bis | Augmentin mf | Avidia | Betaklav | Curam | Enhancin | Medoclav | Taromentin;
  • (MA) Morocco: Aclav | Amoclavin | Augmentin | Biotic plus | Clavulin | Co amoxiclav | Curam | Ecoclav | Levamox | Maxiclav | Neoclav | Novoclin | Saphir | Soclav | Zamox;
  • (MX) Mexico: Acarbixin | Acimox ac | Alvi Tec | Amobay cl | Amoxic+a-clav.gi k | Amoxicil-clavul gi | AMOXICILINA + ACIDO CLAVULANICO | Amoxiclav | Amoxiclav bid | Ampliron Duo | Apoclavox | Augmentin | Augmentin 12 h | Augmentin 12h | Augmentin es | Avuxilan | Caxicum | Clambusil | Clamicil | Clamoval | Clamoxin | Clamoxin 12h | Clamoxin s | Clavant-bid | Clavipen | Clavipen 12h | Clavucyd | Clavucyd bid | Clavulin | Clavulin 12H | Clavuser | Clavuser 12 hrs | Crizmat | Eumetinex | Gimaclav | Gramaxin | Moxlin clv | Penamox 12h duo | Polymox aebal | Polymox duo | Polymox duo 12h | Rapiclav | Servamox clv | Servamox clv 12h | Sinufin | Valclan;
  • (MY) Malaysia: Alvonal | Amocla | Amoxicillin and clavulanate potassium | Amoxiclav | Augmentin | Clamentin | Clamonex | Clamovid | Clamox | Clavam | Clavicin | Clavomax | Clavomid | Cledomox | Co amoxiclav | Co amoxiclav kapl | Co-amoxiclav pharmaniaga | Co-Amoxiclave pharmaniaga | Curam | Enhancin | Fleming | Fugentin | Koact | Moxiclav | Myclav | Rapiclav | Vestaclav | Xinclav;
  • (NG) Nigeria: Adaclav | Adventin | Africlav | Agcloxtin | Amclavin | Amovin | Amoxicillin & clavulanate potassium | Amoxicillin & clavulanic acid | Amoxicillin and clavulanate potassium | Aquaclav | Astamentin | Auglocef | Augmentin | Augulab | Aviclav | Axitin | Benclav | Betalac ac | Betamoclacid | Bg clav | Bond co amoxyclav | Chazmax co amoxiclav | Chemoclav | Chosementin | Clamoxin | Clavamox | Clavatin | Clavugen | Clavulin | Clavulist | Co amoxiclav | Coamoxiclav marcolivia | Digiclav 228 | Digiclav 625 | Dumoclav | Ebeclav | Eglomentin | Exaclav | Fhl co amoxiclav | Foxiclov | G clav | Geozin | Gimbaclav | Imoxclav | Kenop | Koact | Lifeclav | Loxaclav | Lynxiclav | Malmentin | Mannyclav | Maryclantin | Mecure amoxicillin & clavulanic acid | Medoclav | Meem amoxicillin and clavulanate acid | Mentclav | Moko amoxicillin & clavulanate potassium | Moko amoxicillin & clavulanic potassium | Moxymentin | Myclav | Namoxyclav | Nectaclav | Nosclav | Obiclaf | Oroclav | Oxclav | Oxclav forte | Oxynic | Pemaclav | Qualiclav | Rapiclav | Reboklav | Recvanic | Royaclav | Sampravam | Sanclaf | Spectracluvenic | Spingumentin | Sugam | Supermentin | Theoclav | Vistin | Xomox cv | Xymentin | Zamox c | Zamoxc | Zanitin duo | Zeroclav | Ziclav | Zimilat | Zooclav;
  • (NL) Netherlands: Amoxi clavulan stada | Amoxicilline/Clavulaanzuur | Amoxicilline/Clavulaanzuur A | Amoxicilline/Clavulaanzuur Actavis | Amoxicilline/Clavulaanzuur Alpharma | Amoxicilline/clavulaanzuur Apotex | Amoxicilline/Clavulaanzuur aristo | Amoxicilline/Clavulaanzuur Aurobindo | Amoxicilline/clavulaanzuur cf | Amoxicilline/Clavulaanzuur Merck | Amoxicilline/Clavulaanzuur Mylan | Amoxicilline/Clavulaanzuur PCH | Amoxicilline/clavulaanzuur ratiopharm | Amoxicilline/clavulaanzuur sandoz | Amoxicilline/Clavulaanzuur Sandoz | Augmentin | Augmentine;
  • (NO) Norway: Amoclav | Amoxi-clav stada | Amoxiclav | Amoxiclav 1a pharma | Amoxiclav hikma | Augmentin | Bioclavid | Co amoxiclav | Co-amoxiclav | Spektramox;
  • (NZ) New Zealand: Alpha-amoxyclav | Augmentin | Curam | M amoxiclav | Synermox;
  • (OM) Oman: Dioclav;
  • (PE) Peru: Aciclav | Alfamox ac | Ambilan | Amolex | Amoxibac cl | AMOXICILINA + ACIDO CLAVULANICO | Amoxiclin CL 12h | Amoxidal plus | Amoxidin cl | Amoxyseven | Augmentin | Augmentin es | Augmex duo | Augmox | Bioxilina plus | Bramoxal duo | Broncobiotic cl | Clavam duo | Clavicel | Clavinex | Clavoxilin plus | Clavoxilin plus forte | Clavukem | Clavulex | Clavuliph duo | Clavumass | Clavumox | Clavunil | Clavutrim cl | Curam | Deltamox cl | Enhancin | Medimoxilin cl | Movulan | Orabiot CL | Proflox cl | Velamox cl;
  • (PH) Philippines: Addex | Agcomen | Agpen | Alclav | Alclav DS 457 | Altoclav | Altocom | Altovox | Alvonal | Amamcla | Ambiclav | Amoclav | Anbicyn | Antclav | Arvoclav | Atadar | Auget | Augmentin | Augmex | Augurcin | Aumox | Axalav | Bactiv | Bactoclav | Bioclav | Bioclavid | Cavumox | Cax | Clamovid | Clamoxid | Clamoxin | Claneksi | Clanoxy | Claventin | Claverob | Clavinyx | Clavistan | Clavmed | Clavmex | Clavmoxwel | Clavomax | Clavorex | Clavox | Clavoxel | Clavoxtin | Clavsin | Clavuclav | Clovimax | Clovimed | Clovintin | Clovoxclav | Co amoxiclav | Co avox | Co Ax | Co-amoxiclav | Cobiomax | Comox | Comoxitab | Comxicla | Cosmox | Cowamox | Cozeal | Descari | Duoclav | Eleventin | Endclav | Enhancin | Eoclav | Euroclav | Exten | Fleming | Genclav | Geoxiclav | Globantin | Gloclav | Goclav | Gomox | Gravimox | Inoclav | Jamoxi | Julmentin | Klavic | Kmoxilin | Koact | Lewiclav | Lezclav | Lox | Luvmox | Maxlavco | Mediclav | Megaclav | Moxclatab | Moxgen | Myclav | Nahaltin | Natravox | Nexilav | Pediaclav | Pencla | Penhance | Prevaclav | Proviclav | Proxiclav | Qualiclav | Rafonex | Raniclav | Rapiclav | Rhea co amoxiclav | Solclav | Sovlan | Stalmox cl | Sullivan | Truclav | Vexiclav | Viamox | Vispoclav | Xilanic;
  • (PK) Pakistan: Amclav | Amoxynate | Amoxynate dry suspension | Augmentin | Augmex | Augmiclav | Calamox | Calamox Duo | Clamentin | Clamoxin | Clatimox | Clav | Clavopin | Clavumox | Co amoxi | Co amoxi bd | Fortecin | Klavutin | Mentin og | Potentin | Rite | Stamentin | Stamentin ds | Stamentin duo | Stavomox | Termibex | Vulamox | Zamoclav;
  • (PL) Poland: Amoksiklav | Amoxicillin + Clavulanic Acid Aurovitas | Amylan | Auglavin | Auglavin pph | Augmentin | Co amoxiclav | Curam | Forcid | Hiconcil combi | Penlac | Polamoklav | Ramoclav | Recute | Taromentin;
  • (PR) Puerto Rico: Amoxicilin clav/pot | Amoxicillin & clavulanate k | Amoxicillin and clavulanate potassium | Amoxicillin and clavunate potassium | Amoxicillin trihydrate and clavulanate potassium | Amoxicillin/Clav pot | Augmentin;
  • (PT) Portugal: Amoclavam | Amoxicilina + Acido Clavula. Sandoz | AMOXICILINA + ACIDO CLAVULANICO | Amoxicilina + Acido Clavulanico Alter | Amoxicilina + acido clavulanico aurobindo | Amoxicilina + acido clavulanico basi | Amoxicilina + acido clavulanico bluepharma | Amoxicilina + acido clavulanico bluesar | Amoxicilina + Acido clavulanico Ciclum | Amoxicilina + acido clavulanico combino | Amoxicilina + acido clavulanico generis | Amoxicilina + acido clavulanico Generis | Amoxicilina + acido clavulanico hikma | Amoxicilina + Acido Clavulanico Normon | Amoxicilina + acido clavulanico Pharmakern | Amoxicilina + Acido clavulanico Tarmix | Amoxicilina + acido clavulanico Tolife | Amoxicilina + acido clavulanico zentiva | Augmentin | Augmentin Duo | Betamox | Clavamox | Clavamox DT | Clavepen | Penilan;
  • (PY) Paraguay: Ambilan bid | Ambilan bid forte | Amox duo | Amoxicilina acido clavulanico sandoz | Amoxidal plus | Amoxidal plus duo | Anamox clav | Clavinex duo | Clavinex duo forte | Clavulox | Medamox beta | Trixan plus duo;
  • (QA) Qatar: Amoclan | Amoclan BID | Amoclan Forte | Amoclan IV | Amoklavin | Amoklavin ES | Augmentin | Augmentin ES | Augmentin Infant Drops | Augmentin IV | Augmentin SR | Clavodar | Clavodar ES | Clavomox | Curam | Curam IV | Dioclav | E-Moxclav | Enhancin | Gloclav | Hibiotic | Julmentin | Julmentin 2X | Julmentin Forte | Julmentin IV | Klamoks BID 625 | Klamoks BID Fort | Klamoks BID Fort 1000 | Klavox | Koact 1000 | Koact 625 | Medaclav | Megamox | Moxiclav | Neoclav | Ramoclav;
  • (RO) Romania: Amoksiklav | Amoksiklav 2x | Amoxicilina/acid clavulanic aurobindo | Amoxicilina/acid clavulanic krka | Amoxiplus | Augmentin | Augmentin bis | Augmentin es | Augmentin fp | Augmentin sr | Bioclavid | Enhancin;
  • (RU) Russian Federation: Amoclan hexal | Amoclavin | Amoksiklav | Amovicomb | Amoxicillin trihydrate and potassium clavulanate | Amoxicillin+clavulanic acid | Amoxicillin+clavulanic acid pfizer | Amoxicillin+clavulanic acid vial | Amoxiclav | Amoxivan | Arlet | Augmentin | Augmentin es | Augmentin sr | Bactoclav | Betaklav | Clamosar | Ecoclav | Fibell | Foraclav | Foraklav | Klavocin | Liclav | Medoclav | Moxiclav | Novaclav | Panklav | Panklav 2x | Ranclav | Rapiclav | Verklav;
  • (SA) Saudi Arabia: Amoclan | Augmentin | Augmentin sr | Augmoks | Clamoxe | Clavodar | Coamox | Curam | Gloclav | Julmentin | Julmentin ES | Klavox | Medaclav | Megamox | Megamox es | Moxiclav | Ogmant | Oxiclav | Ramoclav;
  • (SE) Sweden: Amoxicillin/clavulanic acid actavis | Amoxicillin/clavulanic acid aurobindo | Amoxicillin/Clavulanic acid BB | Amoxicillin/Klavulansyra 2care4 | Amoxicillin/Klavulansyra Amneal | Amoxicillin/klavulansyra ebb | Betaklav | Bioclavid | Klaximol | Spektramox;
  • (SG) Singapore: Amocla | Anbicyn | Augmentin | Augmex | Clamonex | Clamovid | Co-amoxiclav | Curam | Enhancin | Fleming | Fugentin | Koact | Moxiclav;
  • (SI) Slovenia: Amoksiklav | Augmentin | Betaklav | Betaklav S | Klavocin;
  • (SK) Slovakia: Afreloxa | Amoksiklav | Amoxicillin/clavulanic acid mylan | Amoxicillin/clavulanic acid olikla | Augmentin | Betaklav | Betalactin | Curam | Enhancin | Medoclav | Megamox | Megamox BID | Penlac;
  • (SL) Sierra Leone: Augmentin | Clamoxin | Clavesk;
  • (TH) Thailand: A clav 457 | Acinet | Amk | Amocla | Amoksiklav | Amotin | Amoxclav | Anbicyn | Atmovin | Augclav | Augmentin | Augmentin es | Augpen | Avacan | Bactoclav 375 | Biclav | Cavumox | Clamax | Clanoxy | Clavam | Claventin | Clavicin | Clavico | Clavomid | Clavulin | Coklav | Curam | Fleming | Indclav | Julmentin | Koact | Manclamine | Moxiclav | Moxicle | Oxpen | Ranclav | S clav | Starclav;
  • (TN) Tunisia: Amoclan | Amoxi clav zentiva | Amoxi-clav | Augmentin | Ciblor | Clavor | Mediclav | Novaclav | Vaamox;
  • (TR) Turkey: Amoklavin | Amoksilav | Augmentin | Augmentin BID | Bioment | Bioment-bid | Croxilex | Croxilex-BID | Klamoks | Klavon | Klavon bid | Klavunat | Klavunat es | Klavupen;
  • (TW) Taiwan: Amoclan | Amoclav | Amoclavunin | Anbicyn | Augcin | Augmentin | Curam | Moxiclav | Soonmelt;
  • (UA) Ukraine: A klav | Abiklav | Amoksiklav | Amoksiklav 2s | Amoksiklav 2x | Amoxicillin+clavulanic acid | Amoxicomb | Amoxil k | Amoxil k 1000 | Amoxil k 625 | Amoxypus | Augmentin | Augmentin bd | Augmentin es | Augmentin sr | Bactoclav | Betaklav | Clavam | Coact | Klamoks bid | Klavamitin | Medoclav | Medoclav forte | Panclav;
  • (UG) Uganda: Acinet | Amoxiclav denk | Augmentin | Augmentin bd | Augmentin es | Bactoclav | Bactoclav 1000 | Bactoclav 375 | Bactoclav 625 | Clanoxy | Clavace | Clavam | Clavicin | Clavodar | Clavomid | Clavulin | Claxy | Cledomox | Co amox acino | Fleming | Julmentin | Koact | Magnabiotic | Moxikind | Myclav | Novaclav | Rapiclav | Redamox | S augpro | Spotclav | Spotclav os | Synclav | Syntoclav | Vexapen cp | Wocklav | Xomox cv;
  • (UY) Uruguay: Amoxicilina Clavulanico Winpharm | Amoxidal plus | Amoxidal plus duo | Augmentin | Clavutam | Cluvax | Curam | Dibional | Fabamox duo | Sinot Clav;
  • (VE) Venezuela, Bolivarian Republic of: Amitrexyl-ac | Amoclav | Amoklavin bid | Amoxicilina + acido clavulonico | Amoxicilina + clavulanato de potassio | Amoxicilina acido clavulanico | Amoxicilina con acido clavulanico | Amoxicilina/ clavulonico | Amoxival a.c. | Amoxyplus | Augmentin | Bioclav | Clavoxilin plus | Clavulam | Clavumedc | Clavumox | Curam | Exovis duo | Fulgram | Klamoks | Ranclav;
  • (VN) Viet Nam: Amogentine | Auclanityl | Augbest | Augbidil | Augclamox | Aumakin | Clavart | Enhamox | Imefed | Klamentin | Klamex | Klavunamox | Kuniclav | Nacova dt | Ofmantine | Tedavi | Vigentin;
  • (ZA) South Africa: Actimentin | Adco amoclav | Apex clavutin | Apoclav | Augmaxcil | Augmentin | Augmentin sr | AUGSPEC | Auro amoxiclav | Austell co amoxiclav | Avutan | Betaclav | Bindoclav | Bio-amoksiklav | Camox co amoxiclav | Clamentin | Clavumox | CO AMOXICLAV TRINITY | Co amoxyclav bd austell | Co amoxyclav bd camox | Curam | Forcid | Gulf amoxy co | Moxyclav | Myclav | Ranclav | Rolab-amoclav | Rolab-co-amoxyclave | Sandoz Co-amoxyclav;
  • (ZM) Zambia: Acinet | Amoxiclav | Amoxiclav denk | Augmentin | Augmentin bd | Augpen | Bactoclav | Clanoxy | Clauviax | Clavulin | Cledomox | Dafraclav | Enhancin | Koact | Moxikind cv | Moxileb cv | Myclav | Novaclav | Rapiclav | Sandoz co amoxyclav | Zanitin | Zanitin duo;
  • (ZW) Zimbabwe: Augmentin bd | Augmentine sr | Augumentin es | Co-amoxiclav | Enhancin | Myclav | Rapiclav
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