The protective effect of clavulanic acid in a combined formulation on the concentration of amoxycillin in the urine of patients with urinary tract infections.

Three paraplegic patients with urinary tract infections caused by a beta-lactamase-producing Klebsiella pneumoniae were treated with a combination of amoxycillin and clavulanic acid (A-CA) (Augmentin; Beecham), after initial and unsuccessful therapy with amoxycillin alone. The administration of A-CA resulted in a rapid decrease in the urinary bacterial cell count, coupled with a dramatic increase in urinary amoxycillin concentrations.

The in vitro activity of amoxycillin with clavulanic acid against clinically significant bacteria. A multicentre study.

A multicentre study to evaluate the activity of amoxycillin when combined with clavulanic acid against clinical bacterial isolates was performed in South Africa. Minimum inhibitory concentrations for amoxycillin alone and in combination with clavulanic acid were determined by agar dilution. The majority of amoxycillin-resistant Klebsiella and Escherichia coli strains became sensitive to amoxycillin in the presence of low concentrations of clavulanic acid. Beta-lactamase-producing strains of Staphylococcus aureus showed increased susceptibility to amoxycillin in the presence of clavulanic acid. Minimum bactericidal concentrations indicated that amoxycillin retains bactericidal activity in the presence of clavulanic acid. Enterobacter and Serratia species and Pseudomonas aeruginosa remained amoxycillin-resistant in the presence of clavulanic acid.

[Treatment with amoxicillin and clavulanic acid of urinary tract infections in patients with spinal injuries]. / Terapie van urienweginfeksies by pasiënte met rugmurgbeseringe deur die toediening van amoksisillien en klavulaniese suur.

Augmentin, a formulation of amoxycillin trihydrate 250 mg and sodium clavulanate 125 mg per tablet (A-CS) (Augmentin; Beecham), was used in treating 29 episodes of urinary tract infection occurring in 26 patients admitted to the Spinal Unit of the H. F. Verwoerd Hospital, Pretoria. Patients who had a urinary bacterial cell count of more than 105 of the same amoxycillin-resistant organism before and after the oral administration of amoxycillin 500 mg 3 times a day for 48 hours, received 2 A-CS 375 mg tablets orally, 3 times a day at the start if a meal for 5 days. The 29 strains of amoxycillin-resistant organisms treated in this study were: Escherichia coli (11), Klebsiella pneumoniae (11), Proteus mirabilis (4), Enterobacter cloacae (2), and Staphylococcus epidermidis (1). The bacteriological success rate 24 hours after therapy was 100% and 8 days after therapy 69%, dependent on patient management. In patients on free drainage and managed with condoms a bacteriological success rate of 55,5% was recorded and in patients managed by intermittent catheterization a bacteriological success rate of 75% was recorded. Side-effects were minimal; 1 patient complained of dizziness and no instances of nausea or vomiting were reported. Haematological, renal and hepatic monitoring before and after A-CS-therapy revealed no drug-related toxicity.