From the Guidelines
Yes, clavulanate effectively covers for beta-lactamase production. Clavulanate is a beta-lactamase inhibitor that is commonly combined with beta-lactam antibiotics like amoxicillin (forming amoxicillin-clavulanate, or Augmentin) or ticarcillin. It works by irreversibly binding to and inactivating bacterial beta-lactamase enzymes, which are produced by certain bacteria to break down the beta-lactam ring of antibiotics, rendering them ineffective. By inhibiting these enzymes, clavulanate protects the companion antibiotic from degradation, allowing it to reach its target and exert its antibacterial effect. This combination is particularly useful against beta-lactamase-producing strains of bacteria such as certain Staphylococcus species, Haemophilus influenzae, Moraxella catarrhalis, and some Enterobacteriaceae. However, it's essential to note that clavulanate is not effective against all types of beta-lactamases, particularly those known as extended-spectrum beta-lactamases (ESBLs) or carbapenemases, which require different treatment approaches 1.
Some key points to consider:
- Clavulanate is effective against beta-lactamase-producing bacteria, but its efficacy may vary depending on the specific type of beta-lactamase produced by the bacteria.
- The combination of amoxicillin and clavulanate is a commonly used and effective treatment for various infections, including those caused by beta-lactamase-producing bacteria 1.
- However, the use of clavulanate should be guided by local resistance patterns and the specific type of infection being treated 1.
- In cases where ESBLs or carbapenemases are suspected, alternative treatment approaches may be necessary 1.
In summary, clavulanate is an effective beta-lactamase inhibitor that can be used to treat infections caused by beta-lactamase-producing bacteria, but its use should be guided by local resistance patterns and the specific type of infection being treated. The most recent and highest quality study 1 supports the use of clavulanate in combination with beta-lactam antibiotics for the treatment of various infections.
From the FDA Drug Label
Clavulanic acid is a beta-lactam, structurally related to the penicillins, which possesses the ability to inactivate some beta-lactamase enzymes commonly found in microorganisms resistant to penicillins and cephalosporins. The formulation of amoxicillin and clavulanic acid in amoxicillin and clavulanate potassium tablets protects amoxicillin from degradation by some beta-lactamase enzymes and extends the antibiotic spectrum of amoxicillin to include many bacteria normally resistant to amoxicillin
Yes, clavulanate covers for beta-lactamase production by inactivating some beta-lactamase enzymes, thereby protecting amoxicillin from degradation and extending its antibiotic spectrum 2.
- Key points:
- Clavulanic acid has the ability to inactivate some beta-lactamase enzymes
- The formulation of amoxicillin and clavulanic acid protects amoxicillin from degradation by beta-lactamase enzymes
- This extends the antibiotic spectrum of amoxicillin to include many bacteria normally resistant to amoxicillin 2
From the Research
Clavulanate and Beta-Lactamase Production
- Clavulanate is a potent inhibitor of many bacterial beta-lactamase enzymes, which can increase the spectrum of amoxicillin to include beta-lactamase-producing strains of certain bacteria 3.
- The combination of amoxicillin and clavulanate has been shown to be effective against beta-lactamase-producing strains of E. coli, Klebsiella, Proteus, and Citrobacter 3.
- Clavulanic acid, a component of clavulanate, has been found to decrease the MICs of amoxicillin in beta-lactamase-producing strains of Neisseria gonorrhoeae, Haemophilus influenzae, Escherichia coli, K. pneumoniae, P. mirabilis, Enterobacter cloacae, and Bacteroides fragilis 4.
Mechanism of Action
- Clavulanate works by inhibiting beta-lactamase enzymes, which can break down beta-lactam antibiotics like amoxicillin 5.
- Clavulanic acid has been shown to bind to penicillin-binding proteins (PBPs) in Gram-positive and Gram-negative bacteria, and may have an effect on pathogenic bacteria regardless of beta-lactamase production 6.
Clinical Efficacy
- The combination of amoxicillin and clavulanate has been found to be effective in treating a range of infections, including urinary tract infections, respiratory tract infections, and skin and soft tissue infections 7, 5.
- Clavulanate has been shown to enhance the activity of amoxicillin against non-beta-lactamase-producing organisms, and may have clinical significance in the treatment of certain infections 6.