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Doctors' Answers to "Frequently Asked Questions" - Augmentin

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Augmentin and Alcohol [posted 1/11/99]
Question: May I consume Alcohol while taking Augmentin?

Answer: Ok, but I would limit it.

Augmentin Colon Concerns  [posted 11/24/98]
Question:  I am on about a 2-3 week regime of Augmentin 875 for an ear infection. While I do not have a history of colitis, I would like to minimize bad effects on the colon. What do you think of dietary countermeasures such as yogurt or apple cider?

Answer: Yogurt usually works as well as anything. However, you need natural yogurt not pasturized.

Augmentin & Bowel Difficulties [posted 10/28/98]
Question: I've been taking this drug for a week 875MG 2 times a day and I have a bad case of diarrhea, do I need to stop taking this drug iv had the diarrhea for 5 days. What do I need to do to stop the diarrhea?

Answer: Probably stop the antibiotic. However, if it persists get checked for C. Dificil in the stool. This would require additional treatment.

Augmentin [posted 10/15/98]
Question: Can augmentin cause c.difficile colitis in an infant ?

Answer: Yes.

Augmentin [posted 8/14/98]
Question: My doctor has prescribed Augmentin for a condition he has diagnosed me with called Cellulitis. My question is this, I have looked Cellulitis up on the internet, and the only thing I can see prescribed for itis Eurythromycin. Can you tell me whether I was prescribed the right medicine? because my condition has gotten worse with huge blisters forming on the red itch burning flesh of my upper right leg.

Answer: Cellulitis is an infection of the skin usually caused by gram positive bacteria-occasionally other types. It is usually treated with antibiotics good against gram positive organisms unless there is no response. Augmentin is generally good against both gram positive and negative organisms and would be generally be useful in treating cellulitis. However, medicine judges by results and if it is not responding you need to be reevaluated.

Augmentin [posted 8/14/98]
Question: Recently I was prescribed Augmentin for a skin/soft tissue infection. The day after I started taking it I noticed blood in my stool. I ignored it because my doctor had told me that the medicine would mess up my digestive system. Subsequently, a week later I was admitted to the hospital having severe blood loss. I quit the Augmentin the day before I went to the Hospital. In about four days there was no trace of blood and no one was able to find the cause. Is there any reason to think the augmentin did not cause this bleeding?

Answer: Diarrhea is very common on this drug, bleeding is rare/unusual.

Augmentin [posted 8/12/98]
Question: I just found out that it is contraindicated to use augmentin with disulfiram Why is that?

Answer: News to me - it’s not listed in the PDR under either drug. You might check with the company for more information - SmithKline Beecham: 800-366-8900 ext 5231.

Augmentin Doses in Children [posted 8/5/98]
Question: If a child is prescribed Augmentin 375 mg, how many times a day should the child take it and for how many days? I live in Indonesia and there is conflicting advise here.

Answer: Augmentin can be either twice or three times a day depending on the dosage. The dosage in children is weight based. 45 mg/kg/day for 12 hour and 40 mg/kg/day for 8 hour dosing.

Augmentin and Disulfiram [posted 7/23/98]
Question: I just found out that it is contraindicated to use augmentin with disulfiram. Why is that?

Answer: This is news to me and is not currently listed as a contraindication by the company. You can check with Wyeth-Ayerst to be sure: 800-934-5556.

Question: I am dealing with an bladder infection of e. faecalis. I expect to have to take antibiotics for about 8 months or so (due to undetected bacteria for so long). The problem is dealing with the physical effects of such long term medications and trying to find a happy medium for my liver and body vs. my bladder. What type of liver dysfunction are you talking about when dealing with augmentin? Secondly, since it seems according to reading, that the residuals generally are excreted after about 4-5 hours instead of a three dosage protocol, would not weaker forms for six times a day be a more constant bathing of the bladder? Or could one optimally take the second half of each eight hour time frame to enjoy the taking in of water to help bathe the rest of the body tissues since it seems the bladder would have already gotten its maximum effect after the 4-5 hour limit? I've also heard the acid in augmentin has an effects on normal healthy cells as well. Is this true?

Answer: I'm not sure why you're committed to 8 months of antibiotics unless you have an anatomic problem, stone, etc. You certainly wouldn't need to for most infections and the lack of detection would have nothing to do with the duration of antibiotics needed to sterilize your bladder. I think you need a clearer idea of why you are committed to such a long duration prior to undertaking the task.

Question: My wife came down with a rash all over her body Saturday morning. She has been on augmentin for a week for a small infection on her foot. We called her doctor and we were told she should take benedryl. Today (Sunday) the rash has not moved. It remains the same. Should I bring her to a hospital this morning if it doesn't clear? I am very concerned and the doctor hasn't told us much.

Answer: Rashes are common on penicillin drugs like Augmentin. They can last up to 2 weeks. If there is no respiratory component (shortness of breath, swelling of the tongue, etc.) there is little risk of further problems once the drug is stopped.

Question: I have a cat diagnosed with severe pneumonia which, is being treated with augementin (125 mg twice a day) and dexametasone (1 mg once a day). Since the cat refuses to take medicines orally, the medicines are given by injection (subcut). How long can augmentin be kept in the refrigerator once it has been reconstituted? One bottle (1.2 g) would last normally for 10 shots, or 5 days. The medicines have been bought from a pharmacy in one of the Bangkok hospitals. No detailed information was provided. It mentions only on the outside of the bottle that augmentin should be used immediately after reconstitution.

Answer: The drug does not break down appreciably for several weeks after being reconstituted. However, the risk of super infection of the fluid used to reconstitute the antibiotic rises with time. One or two weeks should be a minimal risk.

Question: What is the appropriate period to treat sinusitis with Augmentin? I am in Mexico and the doctors opinions here differ anywhere from 7 days to 21 days. The dosage seems to be universal: 500 mg bid.

Answer: Augmentin(amoxicillin/clavulanate potassium)is an extremely effective combination of two different antibiotics. The amoxicillin is very effective against many forms of bacteria, but is limited by bacteria resistance patterns. Enter clavulanate potassium which is very effective at blocking certain types of bacterial resistance to penicillin and penicillin like drugs(like amoxicillin). The drug is usually used three times a day and not twice. Five hundred milligrams would be an adequate dose, as would 875 mg twice a day. Sinus infections are notorious for taking long amounts of time to cure. Usually, I start with 7-10 days and if symptoms continue continue, continue for 21-28 days.

Question: The only difference Amoxil and Augmentin have is that Augmentin has an acid in it, correct? Why then would that be prescribed over the Amoxil. What benefit does it have? By the prescribed over the Amoxil. What benefit does the acid have? By the way this was prescribed for otitis media and slight bronchitis.

Answer: Augmentin is a combination of Amoxicillin and Clavulanate potassium. Clavulanate potassium is technically the potassium salt of clavuligerus. It is added to Amoxicillin due to its ability to inactivate beta-lactamases. These are substances produced by bacterial defenses. Amoxicillin has historically been an excellent drug for many infections. However, development of resistance-often due to beta-lactamases has made it less effective. The addition of clavulanate potassium to Amoxicillin has generally made the drug much more effective against resistant bacteria.

Side Effects
Question: What are its side effects?

Answer: Augmentin(amoxicillin/clavulanate potassium) is a combination of amoxicillin(a penicillin like drug) and clavulanate. Clavulanate is a product of the bacteria Streptomyces clavuligerus and is used by this bacteria to inactivate beta lactamases by blocking various enzyme sites. When used with amoxicillin, it allows amoxicillin to kill bacteria without being degraded by the bacterias defense system. Beta lactamase is the primary ring structure of penicillin and associated drugs. Side effects of this drug center on the same side effects as penicillin like drugs;that is, allergy, liver dysfunction, diarrhea. Like any fairly effective antibiotic, it can produce pseudomembranous colitis a particulary nasty form of diarrhea. This is due to overgrowth of a bacteria in the colon called Clostridia Dificil. This bacteria is not sensitive to penicillin and after other bacteria are killed begins to take over the colon. In my experience, diarrhea followed by skin rashes are the most common side effects.

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