From the Guidelines
Augmentin (amoxicillin-clavulanate) is the primary oral medication option, typically dosed at 875/125 mg twice daily, while sulbactam is not available as an oral medication, only in injectable form combined with ampicillin (Unasyn) 1. When considering oral medication options for treating bacterial infections, it's essential to note that Augmentin is available in various formulations, including an extended-release version, Augmentin XR. The dosing for Augmentin can vary based on the severity of the infection and the patient's age and weight. For adults, the typical dose is 875/125 mg twice daily or 500/125 mg three times daily for 7-14 days, depending on the infection severity. For children, the dosing is based on weight, usually 45-90 mg/kg/day divided into two doses.
Key Considerations
- Sulbactam is not available as a standalone oral medication and is primarily used in combination with ampicillin in an injectable form.
- If an oral beta-lactam/beta-lactamase inhibitor is needed, options include Augmentin, Augmentin XR, or alternatives like cefuroxime axetil (Ceftin) or cefpodoxime proxetil.
- These medications work by the beta-lactamase inhibitor protecting the beta-lactam antibiotic from enzymatic degradation by bacteria, extending the spectrum of activity against resistant organisms.
- Common side effects include diarrhea, nausea, and rash, and these medications should be taken with food to minimize gastrointestinal upset.
Treatment Recommendations
- For infections where Augmentin or sulbactam might be considered, such as animal or human bites, the choice of antibiotic should be guided by the suspected or confirmed pathogens and their resistance patterns, as outlined in guidelines like those from the Infectious Diseases Society of America 1.
- The bacteriology of wounds can differentiate the number of isolates per wound and whether additional coverage for anaerobes is required, influencing the choice of antibiotic therapy.
From the FDA Drug Label
11 DESCRIPTION Amoxicillin and clavulanate potassium tablets, USP is an oral antibacterial combination consisting of amoxicillin and the β-lactamase inhibitor, clavulanate potassium (the potassium salt of clavulanic acid).
Each tablet contains 250 mg, 500 mg or 875 mg amoxicillin, USP as the trihydrate and 125 mg clavulanic acid as the potassium salt.
The oral medication options for Amoxicillin-Clavulanate (Augmentin) are:
- 250 mg amoxicillin and 125 mg clavulanic acid
- 500 mg amoxicillin and 125 mg clavulanic acid
- 875 mg amoxicillin and 125 mg clavulanic acid There is no information about Sulbactam (Unasyn) oral medication options in the provided drug label 2.
From the Research
Oral Medication Options
The oral medication options for Augmentin (amoxicillin-clavulanate) include:
- Amoxicillin/clavulanate 2000/125 mg twice daily (available as Augmentin XR in the USA) for adult respiratory tract infection due to drug-resistant pathogens 3
- Amoxicillin/clavulanate 90/6.4 mg/kg/day in two divided doses (Augmentin ES-600) for pediatric use in persistent or recurrent acute otitis media 3
- Augmentin 375 mg tds for the treatment of urinary tract infections 4
Properties and Usage
The properties of oral amoxicillin and clavulanic acid, as well as their usage, have been re-examined in a narrative review 5. This review provides guidance on the use of amoxicillin alone and in combination with clavulanic acid, with emphasis on the preferred use of amoxicillin alone.
Indications and Usage
Amoxicillin-clavulanic acid is often used as empiric therapy for many infectious syndromes in adults and children 5. However, some of these syndromes could be handled with a delayed antibiotic prescription approach or amoxicillin alone. The review provides guidance on indications for amoxicillin versus amoxicillin-clavulanic acid and on optimal oral administration, including choice of combination ratio 5.
Sulbactam (Unasyn) Options
There are no research papers provided to assist in answering the question about sulbactam (Unasyn) options.
Dosage and Administration
The dosage and administration of amoxicillin-clavulanic acid vary depending on the specific formulation and indication. For example, Augmentin 375 mg tds is well tolerated and minimal gastrointestinal side effects occur 4. However, clavulanic acid is more strongly associated with gastrointestinal side effects, including Clostridium difficile infection, and limits the maximum daily dose of amoxicillin that can be given 5.