From the Guidelines
Yes, amoxicillin-clavulanate does provide anaerobic coverage. This combination antibiotic consists of amoxicillin (a penicillin) plus clavulanic acid, which inhibits beta-lactamase enzymes that would otherwise break down the amoxicillin. The addition of clavulanate significantly expands the spectrum of activity to include many anaerobic bacteria, particularly those found in the oral cavity, respiratory tract, gastrointestinal tract, and female genital tract. It is effective against anaerobes such as Bacteroides fragilis, Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus species. This makes amoxicillin-clavulanate a good choice for mixed aerobic-anaerobic infections like aspiration pneumonia, intra-abdominal infections, diabetic foot infections, and bite wounds.
Key Points
- Amoxicillin-clavulanate is effective against a wide range of anaerobic bacteria, including those found in the oral cavity, respiratory tract, gastrointestinal tract, and female genital tract 1.
- The combination of amoxicillin and clavulanic acid provides a broad spectrum of activity, making it a good choice for mixed aerobic-anaerobic infections 1.
- Typical adult dosing ranges from 875/125 mg twice daily to 500/125 mg three times daily, depending on the severity of infection and local resistance patterns 1.
- The drug should be taken with food to minimize gastrointestinal side effects and improve clavulanate absorption.
Anaerobic Coverage
- Amoxicillin-clavulanate provides coverage against anaerobes such as Bacteroides fragilis, Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus species 1.
- The addition of clavulanate to amoxicillin expands the spectrum of activity to include many anaerobic bacteria, making it a good choice for mixed aerobic-anaerobic infections 1.
From the FDA Drug Label
Amoxicillin/clavulanic acid has been shown to be active against most isolates of the following bacteria, both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section ... Anaerobic Bacteria Bacteroides species including Bacteroides fragilis Fusobacterium species Peptostreptococcus species
Yes, amoxicillin-clavulanate (Augmentin) has anaerobic coverage against certain anaerobic bacteria, including Bacteroides species, Fusobacterium species, and Peptostreptococcus species 2.
From the Research
Anaerobic Coverage of Amoxicillin-Clavulanate
- Amoxicillin-clavulanate has been shown to have effective anaerobic coverage in various studies 3, 4, 5, 6, 7
- A study published in 2003 demonstrated the efficacy and safety of amoxicillin-clavulanate in the treatment of anaerobic lung infections, with all but one of the 48 microorganisms isolated being susceptible to the drug 3
- Another study from 2017 found that amoxicillin-clavulanate had an in-vitro susceptibility rate of 94% against anaerobic bacteria, making it one of the most effective antibiotics against these organisms 4
- The combination of amoxicillin and clavulanic acid has been shown to be active against a wide range of anaerobic bacteria, including Bacteroides fragilis and other members of the B. fragilis group 6
- Time-kill studies have also demonstrated the effectiveness of amoxicillin-clavulanate against anaerobic bacteria, with the drug showing 99.9% killing of seven strains after 48 hours at the MIC 7
Specific Anaerobic Bacteria Covered
- Amoxicillin-clavulanate has been shown to be effective against various anaerobic bacteria, including:
Comparison to Other Antibiotics
- Amoxicillin-clavulanate has been compared to other antibiotics in terms of its anaerobic coverage, including:
- Imipenem, which was found to be the most potent agent against all strains tested 6
- Metronidazole, which was found to be active against all anaerobes except Propionibacterium acnes 7
- Clindamycin, which was found to be active against all anaerobes except Peptostreptococcus magnus and Bacteroides thetaiotaomicron 7