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PubMed1982

beta-Lactamases of Branhamella catarrhalis and their inhibition by clavulanic acid.

Three of four clinical isolates of Branhamella catarrhalis from Belgium produced a beta-lactamase identical to enzymes previously reported to occur in French and British isolates of this organism. One strain, however, produced a new type of beta-lactamase. Both beta-lactamase types were readily inhibited by low concentrations of clavulanic acid.

Aerobiosis↗
PubMed1994

Interpretive criteria for susceptibilities of Haemophilus influenzae to ampicillin, amoxicillin, and amoxicillin-clavulanic acid.

One hundred fifty isolates of Haemophilus influenzae (including 30 beta-lactamase-positive strains and 23 beta-lactamase-negative, ampicillin-resistant strains) were tested for susceptibilities to ampicillin, amoxicillin, and amoxicillin-clavulanic acid (A/C) by the broth microdilution method in Haemophilus test medium (HTM) and in Mueller-Hinton medium with lysed horse blood and by the disk diffusion method on HTM agar. Our results support the use of HTM for susceptibility testing of H. influenzae but raise a number of questions regarding the interpretive criteria currently in use, particularly with respect to the fourfold difference in MIC susceptibility breakpoints for ampicillin and A/C and a resulting high proportion of A/C-susceptible beta-lactamase-negative, ampicillin-resistant strains.

Amoxicillin↗
PubMed2002

Experimental application of the median-effect principle for in vitro quantification of the combined inhibitory activities of clavulanic acid and imipenem against IRT-4 beta-lactamase.

Inhibitor-resistant TEM beta-lactamases (IRT) have been identified in Enterobacteriaceae which, however, remained susceptible to cephalosporins. We evaluated the combined inhibitory activity of clavulanic acid and imipenem at ratios of 1:1 and 1:3 against IRT-4, using the median effect principle of Chou and Talalay. The combination of the two drugs, which produced a nearly additive effect, meant their concentrations could be lowered 1.3-4.9-fold, while maintaining a 50% inhibitory effect against the IRT-4 in comparison with each drug alone. From a therapeutic point of view, such a combination is not efficient but this method of Chou and Talalay, used for the first time to assay combined inhibitory activity of beta-lactamase inhibitors, could be used to evaluate new molecules and/or strategies to inactivate beta-lactamase.

Anti-Bacterial Agents↗
PubMed1989

An open, comparative evaluation of amoxycillin and amoxycillin plus clavulanic acid ('Augmentin') in the treatment of bacterial pneumonia in children.

One hundred children with clinically diagnosed bacterial pneumonia were assigned at random to receive treatment with either amoxycillin (250 or 500 mg) or amoxycillin (250 or 500 mg) plus clavulanic acid (62.5 or 125 mg) 3-times daily, dosage and duration of treatment being determined by the severity of the condition. There were no clinically significant differences between the two groups on entry and the mean duration of treatment was 6.8 days in both. By Day 3 of treatment, significant differences in improvement in chest pain, dyspnoea, pyrexia and sputum production were noted in favour of amoxycillin/clavulanic acid. The response to treatment was significantly better in the combination group with an excellent or good response recorded in 60% and 30% of patients, compared with 26% and 36% in the amoxycillin group. Only 2 adverse reactions were reported, 1 case each of skin rash and diarrhoea in the combined group. The overall clinical efficacy rate of 93.8% in amoxycillin/clavulanic acid-treated patients was significantly better than the 60.4% clinical success recorded in the amoxycillin group.

Administration, Oral↗
PubMed1993

Susceptibilities of beta-lactamase-producing and -nonproducing ampicillin-resistant strains of Haemophilus influenzae to ceftibuten, cefaclor, cefuroxime, cefixime, cefotaxime, and amoxicillin-clavulanic acid.

In in vitro studies we evaluated the susceptibilities of beta-lactamase-producing and -nonproducing, ampicillin-resistant strains of Haemophilus influenzae and compared them with those of ampicillin-susceptible strains. Ampicillin, amoxicillin-clavulanic acid, ceftibuten, cefaclor, cefuroxime, cefixime, and cefotaxime were evaluated by broth microdilution tests and disk diffusion tests. The disk diffusion tests accurately categorized beta-lactamase-producing strains and ampicillin-susceptible strains as being susceptible to the study drugs other than ampicillin. Ampicillin-resistant, beta-lactamase-nonproducing strains were relatively resistant to all seven study drugs, but the disk diffusion test did not always predict that resistance. The clinical relevance of the decreased susceptibility to various agents remains unclear, but to be conservative, all ampicillin-resistant, beta-lactamase-nonproducing strains might be assumed to be resistant to other beta-lactams. After excluding that small group of isolates, reliable susceptibility test results were obtained with lots of Haemophilus Test Medium that met quality assurance criteria.

Amoxicillin↗
PubMed1982

Amoxicillin and clavulanic acid combination: clinical and laboratory evaluation in pulmonary infections.

Twenty-four patients with pulmonary infections (7 pneumoniae, 17 exacerbations of chronic bronchitis) were treated with a combination of 250 mg of amoxicillin and 125 mg of clavulanic acid supplemented by 500 mg of amoxicillin every eight hours. All patients showed good clinical, roentgenological, and bacteriological response. Bacteria were cleared from sputum by the third day of treatment in half of the patients and by the end of treatment in all but one of the others. Pathogens eradicated from sputum, with concurrent clinical cure, included gram-negative bacteria producing cephalosporinases shown to be resistant to the combination drug by both disk and minimal inhibitory concentration determinations.

Adult↗
PubMed1987

[Urinary tract infections in children. Status in a pediatric hospital and sensitivity of bacterial strains to amoxycillin-clavulanic acid combination].

Three hundred bacterial strains from positive urine cultures were isolated over a 10 months period in paediatric hospitalized and out-patients. In addition to commonly used antibiotics, each strain was tested for amoxycillin-clavulanic acid (Augmentin, Beecham) susceptibility. This antibiotic, which is a potent inhibitor of bacterial beta lactamases, may be of interest in the treatment of urinary tract infections because of its pharmacokinetics and activity. The antibacterial activity of amoxycillin and Augmentin against Enterobacteriaceae with special reference to Escherichia coli was compared. The resistance phenotype of Enterobacteriaceae to amoxycillin, carbenicillin and cephalothin allows to anticipate the nature of the beta-lactamase produced by a particular strain, and infer the activity of Augmentin. The overall activity of Augmentin should be interpreted taking into account the resistance phenotypes. In our study, Augmentin was active against 90% of E. coli strains, almost all Proteus mirabilis and vulgaris strains but 9 out of 24 Klebsiella strains were resistant. Augmentin had no activity against nosocomial Enterobacteriaceae, nor against Pseudomonas aeruginosa. On the other hand, its activity was of interest against penicillinase producing Staphylococcus. Our results confirm the interest of Augmentin as a preferential treatment of urinary tract infections in children.

Amoxicillin↗
PubMed1990

[Amoxicillin associated with clavulanic acid. Clinical efficacy and tolerance].

The Authors, after having analysed the problems involving the choice of an antibiotical therapy in the odontostomatological field, present a study concerning the evaluation of the clinical efficacy and tolerability of Amoxycillin associated with clavulanic acid. This drug has been orally administered to 154 ambulatorial patients. The results thus obtained in this clinical sperimentation show that Stacillin is a good and efficacious antibiotic in odontostomatologic affections, and that it is also well tolerated. These characteristics make it a first choice antibiotic in the odontostomatologic sphere.

Adolescent↗
PubMed1995

[Comparative study of cefixime versus amoxicillin-clavulanic acid combination in the oral treatment of urinary tract infections in children].

BACKGROUND: Acute febrile infections suggestive of pyelonephritis require treatment by broad-spectrum antibiotics capable of reaching significant tissue levels. This study compares efficacy and safety of cefixime with amoxycillin + clavulanic acid in urinary tract infections. POPULATION AND METHODS: Fifty seven children aged 5 months to 14 years treated for urinary tract infection in ten pediatric centres for a period of 10 months had been randomly included in the study. Thirty (22 girls and eight boys) were given cefixime and 27 (24 girls and three boys) amoxycillin-clavulanate. Efficacy was evaluated in only 36 patients whose bacteria were susceptible to both antibiotics (26 pyelonephritis and ten cystitis). RESULTS: Sixteen patients out of the 19 given cefixime recovered vs. 14 out of the 17 given amoxycillin-clavulanate with no significant difference between both groups. Bacteria were more often susceptible to cefixime (100% of cases) than to amoxycillin-clavulanate (69%) (p < or = 0.0001). Safety was good and comparable in both groups. CONCLUSION: Cefixime given per os seems effective and safe in treating urinary tract infections. These results have to be confirmed by further studies.

Administration, Oral↗