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At least 451 records · Page 25Linked to original sources
PubMed1988

Amoxycillin-clavulanic acid (Augmentin) antibiotic prophylaxis against wound infections in renal failure patients.

A randomized, controlled trial of the use of amoxycillin with clavulanic acid (Augmentin) for prophylaxis against wound infections following major surgery, including transplantation, in patients with chronic renal failure, was undertaken. Six of 22 control patients developed wound infections (27%) whereas no patient in the treatment group (24) developed a wound infection (P less than 0.05). After the termination of this trial, the next 35 consecutive patients received prophylactic amoxycillin/clavulanate; of these only two developed wound infections associated with leakage from their pancreatic anastomoses. All the wound infections were shown to be caused by bacteria sensitive to amoxycillin/clavulanate. Pharmacokinetic studies in patients have shown that a bactericidal concentration of the drugs was present for up to 20 h post-operatively in patients on dialysis, and in recipients of non-functioning renal transplants. In patients with normal renal transplant function excretion of the drug within 12 h was observed.

Adult↗
PubMed2006

Influence of feeding conditions on clavulanic acid production in fed-batch cultivation with medium containing glycerol.

First, the effect of different levels of nitrogen source on clavulanic acid (CA) production was evaluated in batch cultivations utilizing complex culture medium containing glycerol and three different levels of soy protein isolate (SPI). Cellular growth, evaluated in terms of the rheological parameter K, was highest with a SPI concentration of 30 g.L(-1) (4.42 g.L(-1) N total). However, the highest production of CA (380 mg.L(-1)) was obtained when an intermediate concentration of 20 g.L(-1) of SPI (2.95 g.L(-1) total N) was used. To address this, the influences of volumetric flow rate (F) and glycerol concentration in the complex feed medium (Cs(F)) in fed-batch cultivations were investigated. The best experimental condition for CA production was F=0.01 L.h(-1) and Cs(F)=120 g.L(-1), and under these conditions maximum CA production was practically twice that obtained in the batch cultivation. A single empirical equation was proposed to relate maximum CA production with F and Cs(F) in fed-batch experiments.

Bioreactors↗
PubMedDate not supplied

In vitro activity of aminopenicillins combined with sulbactam, clavulanic acid, or amdinocillin against bacteria isolated from patients with complicated urinary tract infections.

The minimal inhibitory concentrations (MICs) of ampicillin, sulbactam/ampicillin, clavulanic acid/amoxicillin, and amdinocillin/ampicillin were determined for 400 bacteria isolated from the urine of 400 urologic inpatients with complicated and/or hospital-acquired urinary tract infections (UTIs). The spectrum of isolates consisted of about one-third each of Escherichia coli, other gram-negative strains, and gram-positive strains. About one-third of all isolates were resistant to ampicillin (MICs greater than 8 micrograms/ml). Combination of an aminopenicillin with a beta-lactamase inhibitor improved the activity of the aminopenicillin against gram-negative as well as gram-positive strains. The combination of ampicillin with amdinocillin improved the activity of ampicillin against gram-negative strains only. If the total antibacterial spectrum is considered, the improvements in activity provided by the three combinations were quite similar.

Amdinocillin↗
PubMed1993

Clinical pharmacokinetics of theophylline during co-treatment with ticarcillin plus clavulanic acid in patients suffering from acute exacerbation of chronic bronchitis.

The effect of ticarcillin/clavulanic acid, taken for 7 days as vials containing 1000 mg of ticarcillin and 200 mg of clavulanic acid twice daily intramuscularly, on the steady-state pharmacokinetics of theophylline was studied in 12 patients suffering from acute exacerbation of chronic obstructive pulmonary disease. Initially, patients were treated for four days with theophylline as sustained-release formulation in the amount of 600 mg daily; on the last day, blood samples were taken for theophylline determination. Theophylline concentrations were measured serially for 12 hours by the method of polarized immunofluorescence (Abbott TDx system). Subsequently, while theophylline was continued at the same dosage, each patient received in addition ticarcillin/clavulanic acid vials every 12 hours. After seven days of this combined medication, the serial assays of plasma were repeated at the same time intervals as before. No influence of ticarcillin/clavulanic acid was detectable on the steady-state theophylline pharmacokinetics. It is concluded that both drugs can be administered concomitantly without any dosage adjustment of theophylline.

Bronchitis↗
PubMed1998

In vitro activities of ampicillin-sulbactam and amoxicillin-clavulanic acid against Acinetobacter baumannii.

In vitro susceptibility patterns of newer beta-lactamase-inhibiting antibiotics ampicillin-sulbactam (A/S) and amoxicillin-clavulanic acid (A/C) for 100 consecutive isolates of Acinetobacter baumannii obtained from various clinical samples were studied. The A/C MIC for 86% of the strains was more than 16/8 microgram/ml, whereas there was an A/S MIC of more than 16/8 microgram/ml for only 38% of the strains. This showed that A/S has significantly superior in vitro activity compared to A/C against A. baumannii, although, theoretically, both should have similar activities. The therapeutic superiority of A/S over A/C needs to be studied, or else the breakpoints for these agents in in vitro tests need to be redefined.

Acinetobacter↗
PubMed1984

[Potential value of the amoxicillin-clavulanic acid combination in general medicine, gynecology-obstetrics and pediatrics departments].

This study compares the probability of in vitro activity of amoxicillin-clavulanic acid combination (AMOX-CLA) with those of amoxicillin (AMOX), cephalothin (CEPH), cotrimoxazole (COT) and nalidixic acid (NAL) on the 2 003 strains isolated during the first semester of 1983 in 5 wards of medicine (MED), 2 of gynecology-obstetrics (GYN) and 1 of pediatrics (PED) at the Pitié-Salpêtrière Hospital. As expected, AMOX-CLA was active on most of the strains of S. aureus, E. coli, P. mirabilis, Klebsiella and Bacteroides resistant to AMOX. AMOX-CLA was active on 70 to 86% of all strains, a higher rate than that of AMOX in all situations taken in concert. AMOX-CLA was more often active than AMOX on urinary strains by 17% in MED and GYN, 26% in neonates and 37% in children; it was more often active by 16% on strains isolated from the genital tract and from specimens taken at birth, and by 43% on strains isolated from pus. AMOX-CLA showed the same activity rate as CEPH whatever the infection and was as often active as COT and NAL on urinary strains in MED. On the opposite, activity rates of AMOX-CLA were lower by 6 to 15% than those of COT and NAL on urinary strains in GYN and PED of COT on strains isolated from pus in MED, GYN and PED. Therefore, AMOX-CLA was superior to AMOX in every case, and comparable to CEPH and often COT and NAL, whose use is restricted in pregnant women and neonates owing to side effects.

Amoxicillin↗
PubMed1982

Cefoxitin, N-formimidoyl thienamycin, clavulanic acid, and penicillanic acid sulfone as suicide inhibitors for different types of beta-lactamases produced by gram-negative bacteria.

Cefoxitin, N-formimidoyl thienamycin (MK0787), clavulanic acid, and penicillanic acid sulfone (CP45,899) were studied to determine their potency as suicide inhibitors of three very different kinds of beta-lactamases produced by Gram-negative bacteria: type Ib penicillinase (TEM-2 type), a typical cephalosporinase (the enzyme of Proteus morganii), and a cephalosporinase with broad substrate specificity (the enzyme of Proteus vulgaris). All these beta-lactams were confirmed to be quite stable to the three beta-lactamases. The absolute values of the turnover numbers (kcat) for these enzyme-catalyzed hydrolyses were determined, the values ranged from 0.25 minute-1 to 660 minute-1. All the beta-lactams studied, except cefoxitin, acted as suicide inhibitors of the typical cephalosporinase. Although cefoxitin did not exhibit such an effect, it was a powerful competitive inhibitor of this enzyme. Although the four beta-lactams acted as suicide inhibitors of the P. vulgaris cephalosporinase, the inactivated enzyme partially regained its activity after removing the effect of the free inhibitor. Type Ib penicillinase was also inactivated by the four beta-lactams, and the activity of the inactivated enzyme, except in the case of cefoxitin, was partially restored. The rate constants for enzyme inactivation or reactivation were calculated and are presented. The information obtained from this study suggests that the catalytic center of the P. vulgaris cephalosporinase is different not only from that of the penicillinase-type but also from that of the cephalosporinase-type beta-lactamases.

Anti-Bacterial Agents↗
PubMed1992

[Efficacy and tolerance of a new formulation of amoxicillin 100 mg--clavulanic acid 12.5 mg in acute otitis in infants].

A multicenter study of the new pediatric formulation of Augmentin (containing 100 mg amoxicillin and 12.5 mg clavulanic acid per ml) in acute otitis media (AOM) in patients aged three months to three years was carried out by hospital-based pediatricians. Study patients seen at the hospital outpatient clinics were given the drug in a daily dosage of 80 mg in three (83% of cases) or four (15%) divided doses for 6 to 10 days; 28% of patients were also given an antiinflammatory agent. A total of 83 patients with a mean age of 13.5 months were included (89% of patients were less than two years of age); one-third of these patients were included after failure of another antimicrobial agent (macrolide 46%, cephalosporin 23%). The AOM was bilateral in most patients (69.5%) and 46% of patients had a history of previous AOM. Temperature was elevated in 85% of cases and more than half the patients had gastrointestinal symptoms (vomiting, diarrhea) prior to initiation of the study drug. At the interim evaluation on the fourth treatment day, tympanic membranes were normal in 43.5% of cases and improved in 22% of cases. Over 92% of patients achieved resolution of their AOM by the end of the treatment period, regardless of whether or not myringostomy had been performed on Do. Among the 27 patients given the study drug as rescue therapy after failure of another antimicrobial, 24 (89%) recovered fully.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1989

Biliary elimination of ticarcillin plus clavulanic acid (Claventin): experimental and clinical study.

The aim of the present study was to assess the biliary elimination and disposition of Claventin, a combination of clavulanic acid (CA), a beta-lactamase inhibitor, with ticarcillin (TIC), resulting in an enhancement of the activity of the antibiotic and broadening of its antibacterial spectrum. This work was done experimentally and in humans. Assays of both molecules were performed by HPLC. During a 3 h perfusion of five isolated rabbit liver preparations, 1.3 +/- 0.2% and 0.4 +/- 0.1% of TIC and CA added to the circulating blood were eliminated in the bile. At the same time, 31.8% of TIC and 50.5% of CA were submitted to a hepatic biotransformation. In healthy subjects (n = 5), after a single i.v. injection of 3.2 g of Claventin (TIC: 3 g + CA: 0.2 g) mean peak concentrations of 66.8 +/- 31.9 micrograms/ml (TIC 4th h) and 0.3 +/- 0.1 microgram/ml (CA, 2nd h) were observed in the aspirated duodenal fluid where 0.07% and 0.01%, respectively, of the administered dose were recovered during the 4 h investigation period. In cholecystectomized patients (n = 10) provided with a T-tube, i.v. administration of Claventin, 3.2 g, resulted in biliary maximal levels of 177 +/- 49 micrograms/ml (TIC: 2nd h) and 2.7 +/- 0.5 microgram/ml (CA 1st h). Total amount of each derivative eliminated in bile over 12 h averaged 0.28% (TIC) and 0.05% (CA) of the given dose. Hepatobiliary clearance was 20.5 ml/h (TIC) and 4.4 ml/h (CA). In intra-operative simultaneously sampled specimens of serum, choledochal bile, gallbladder bile and gallbladder wall, the following concentrations were measured 1 h after i.v. administration of Claventin: TIC: 105 +/- 10; 386 +/- 66; 72 +/- 20 micrograms/ml and 36 +/- 11 micrograms/g, CA: 3.5 +/- 0.7; 5.9 +/- 1.5; 0.3 +/- 0.3 microgram/ml and 0.1 +/- 0.1 microgram/g. The biliary pharmacokinetics determined in humans makes it possible to consider favourably the prophylactic use of Claventin in surgery of the biliary tree and constitute a good prerequisite for a possible beneficial treatment of biliary tract infections.

Adult↗
PubMed1991

Comparison of single-dose administration and three-day course of amoxicillin with those of clavulanic acid for treatment of uncomplicated urinary tract infection in women.

In a double-blind randomized study we compared a single-dose amoxicillin-clavulanate combination with a regular 3-day regimen in 109 women with cystitis. Clinical cure rates at 7 and 28 days posttreatment were 78 versus 87% and 67 versus 78%, respectively. The 3-day regimen was significantly better (P less than 0.001) only in women with recurrent urinary tract infections.

Adolescent↗
PubMed1997

Clarithromycin versus amoxicillin-clavulanic acid in the treatment of community-acquired pneumonia.

In an open, prospective, randomised study, the clinical and bacteriological efficacy of intravenously administered clarithromycin was compared with that of amoxicillin-clavulanic acid in 112 patients with community-acquired pneumonia requiring hospitalisation. Clinical cure or improvement occurred in 86% (48/56) of the clarithromycin-treated patients and 84% (47/56) of the amoxicillin-clavulanic acid-treated patients. The rate of bacteriologic eradication was similar for the two drugs as were the rapidity of a clinical response and the rate of improvement of radiological signs. Clarithromycin had a slightly higher rate of side-effects mainly due to phlebitis caused by the intravenous treatment, but treatment could be continued in all cases. Clarithromycin should be used with caution in patients being treated with digoxin because of a significant risk of bradycardia resulting from drug interaction.

Adult↗