AMS bulletin - October 2022
Amoxicillin/clavulanic acid – is it necessary? Amoxicillin/clavulanic acid (Amoxicillin/clavulanate; Curam®; Augmentin®) is an important and effective broad-spectrum antibiotic which is frequently used in hospital and community practice. Due to a significant supply shortage, amoxicillin/clavulanic acid may not be available. Place in therapy Oral amoxicillin/clavulanic acid is rarely seen as a first line antibiotic for the treatment of common bacterial infections. There are only a few indications where it is recommended as a first line antibiotic, e.g. bites (human or animal) and diabetic foot infections. This is due to the large range of potential causative organisms associated with these infections. The table below outlines the indications and alternative antibiotics for use in Community and Hospital guidelines. Unwanted effects of amoxicillin/clavulanic acid Serious adverse effects are rarely seen with amoxicillin/clavulanic acid, although clavulanateassociated cholestatic jaundice has been reported. It occurs in approximately 1 in 6000 patients 1. The reaction may occur up to 6 weeks after completion of the course and is usually reversible 2. Other adverse effects may also include diarrhoea; nausea; vomiting; indigestion; gastrointestinal upset; rash or fungal infections. Using broad spectrum antibiotics also increase the risk of Clostridium difficile infections and other resistant organisms emerging through overuse1. Conclusion
Think twice about prescribing amoxicillin/clavulanic acid. It is rarely recommended as first line treatment.
Especially during this supply shortfall, please use alternative treatment options.
Contact your pharmacist or the ID team for advice.
Developed as part of the AMS Programme