Correct Ratio of Amoxycilin With Clavunic Acid

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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Question
On 27th I asked about correct ratio of Amoxycilin with Clavunic Acid which was replied as 2:1 Amoxycilin to Clavunic Acid. 200mg of Amoxycilin with 28.5 mg of Clavunic Acid preparation is available and claimed to be superior to Amoxycilin for Respiratory Tract Infection. IAP also recommends this combination for treatment of Acute Otitis Media. Please mention the ratio suitable for Respiratory Tract Infections.
Answer
You may read this article published in Journal of Antimicrobial Chemotherapy (2003) 51, 373Ã¢-378. Recent reports have mentioned that ratio of 4:1 may also be efficacious and some reports also mention 8:1. However the time tested dose of 2:1 has been the standard. The aims of this investigation were to calculate the pharmacokinetic parameters of amoxicillin and clavulanic acid, and to identify parameters that may affect their observed differences in absorption. Data were obtained from plasma concentration time curves from four different open, randomized, two-treatment, two-period, two-sequence, crossover Phase I bioequivalence studies, with the following co-amoxiclav formulations: tablets 250/125, 500/125 and 875/125 mg, or 10 mL of an oral suspension 250/62.5 mg per 5 mL. Data from 144 subjects and 288 drug administrations were available for evaluation. After a 125 mg clavulanic acid dose (administered as potassium clavulanate) for all four different formulations, the clavulanic acid AUCt data ranged from 1.5 to 8 mgh/L, varying by a factor of 5. The absorption of clavulanic acid was not related to the absorption of amoxicillin, or demographic factors, and we were unable to identify the reasons for the large variability in the absorption of clavulanic acid. We conclude that the absorption of clavulanic acid, after oral administration, is highly variable and may vary over a five-fold range between patients. Back to All Questions

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