From the Guidelines
Augmentin (amoxicillin-clavulanate) is effective against many anaerobic bacteria, making it a suitable choice for infections where anaerobes are likely contributors. This antibiotic combines amoxicillin with clavulanic acid, which inhibits beta-lactamase enzymes that would otherwise break down amoxicillin, providing good coverage against many gram-positive aerobes, some gram-negative aerobes, and importantly, many anaerobic bacteria including Bacteroides fragilis, Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus species 1. According to the 2014 update by the Infectious Diseases Society of America, amoxicillin-clavulanate is recommended for infections following animal or human bites, which are often polymicrobial and include anaerobic organisms 1.
Key points to consider when using Augmentin for anaerobic coverage include:
- The combination of amoxicillin and clavulanic acid provides broad-spectrum activity against aerobic and anaerobic bacteria
- Augmentin is particularly useful for mixed aerobic-anaerobic infections such as aspiration pneumonia, intra-abdominal infections, diabetic foot infections, and certain skin and soft tissue infections
- Common dosing for adults is 875/125 mg twice daily or 500/125 mg three times daily for 7-14 days, depending on the infection being treated
- For severe anaerobic infections, other agents like metronidazole or carbapenems might be preferred, as they have more targeted activity against anaerobic bacteria 1.
It's also important to note that the bacteriology of wounds can vary, and empirical therapy might miss pathogens, highlighting the importance of considering the specific type of infection and the potential pathogens involved when selecting antimicrobial therapy 1.
From the Research
Anaerobic Coverage of Augmentin
- Augmentin, a combination of amoxicillin and clavulanate, is a broad-spectrum antibacterial agent 2.
- The combination of a penicillin and a beta-lactamase inhibitor, such as amoxicillin plus clavulanate, is effective against anaerobes 3, 4.
- Augmentin is included in guidelines and recommendations for the treatment of bacterial infections, including those caused by anaerobes 2.
- However, the primary use of Augmentin is in the treatment of community-acquired respiratory tract infections, and its effectiveness against anaerobes is not its primary indication 2.
Effective Antimicrobials Against Anaerobes
- The most effective antimicrobials against anaerobes are metronidazole, carbapenems, combinations of a beta-lactam and a beta-lactamase inhibitor, chloramphenicol, tigecycline, and clindamycin 3, 4.
- Metronidazole is still considered the criterion standard for therapy of anaerobic infections 5.
- Augmentin, while effective against some anaerobes, is not the first-line treatment for anaerobic infections 3, 4.