From the Guidelines
For a patient allergic to Augmentin (amoxicillin-clavulanate), cefdinir is a recommended alternative antibiotic due to its low risk of cross-reactivity with penicillin allergy and effectiveness against common bacterial pathogens 1. When considering alternative antibiotics for a patient with an allergy to Augmentin, it's crucial to assess the type of infection, the severity of the allergy, and the local resistance patterns.
- For patients with a history of penicillin allergy, the risk of cross-reactivity with cephalosporins, such as cefdinir, is lower than historically reported, making them a viable option 1.
- Cefdinir, in particular, has been shown to be effective in treating infections such as acute otitis media, with a low risk of cross-reactivity with penicillin allergy 1.
- The choice of alternative antibiotic should be guided by the suspected pathogens, the site of infection, and patient factors, with consideration of the latest evidence on antibiotic resistance and effectiveness.
- It's also important to document the nature of the Augmentin allergy, as true penicillin allergies are less common than reported, and this information can help guide future antibiotic choices 1.
- In cases where the severity of the infection requires broad coverage, consultation with an infectious disease specialist may be necessary to determine the safest and most effective alternative antibiotic regimen.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Alternative Antibiotics to Augmentin
For patients with an allergy to Augmentin (amoxicillin-clavulanate), alternative antibiotics can be prescribed. Some options include:
- Levofloxacin, a fluoroquinolone antibacterial agent, which has been shown to be effective in treating various infections, including respiratory tract infections, skin and soft tissue infections, and urinary tract infections 2
- Cefdinir, an extended-spectrum cephalosporin, which has been found to be as efficacious as levofloxacin in treating acute rhinosinusitis of presumed bacterial etiology 3
Efficacy of Levofloxacin
Levofloxacin has been demonstrated to be effective in treating various infections, with clinical success rates ranging from 78 to 96% and bacteriological eradication rates ranging from 77 to 100% 2. It has also been shown to be at least as effective as amoxicillin/clavulanate plus clarithromycin in treating community-acquired pneumonia 4.
Considerations for Penicillin-Allergic Patients
For patients with a penicillin allergy, levofloxacin can be a suitable alternative, as it has been shown to be effective in treating various infections, including those caused by Streptococcus pneumoniae 2, 5. However, it is essential to consider the patient's specific infection and medical history when selecting an alternative antibiotic.
Comparison with Other Antibiotics
Levofloxacin has been compared to other antibiotics, including cefdinir and amoxicillin/clavulanate, and has been found to be effective in treating various infections 2, 3, 4. The choice of antibiotic will depend on the specific infection, patient factors, and local resistance patterns.