Parenteral Manual

Amoxicillin-Clavulanate

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Classification: 
Antibiotic with beta-lactamase inhibitor
Original Date: 
July 2020
Indications: 
  • Empiric prophylaxis and treatment of animal and human bite wounds
  • Empiric treatment of chronic sinusitis requiring IV therapy
  • Treatment of prolonged appendicitis in patients who have received aminoglycosides > 8 days
Reconstitution and Stability: 
  • Reconstitute vial with 20 mL of sterile water for a final concentration of 50 mg amoxicillin/mL
  • Reconstituted vials stable for 15 minutes at room temperature
  • Diluted solutions stable for 1 hour at room temperature or 4 hours refrigerated

Available formulation: 1000 mg amoxicillin/200 mg clavulanic acid vial

Compatibility: 
  • Solutions: 0.9% NaCl, Lactated ringers
  • Additive: No information
  • Y-site compatible: Lorazepam, pantoprazole, propofol, vancomycin
Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC No
IM No
IV direct Yes for doses > 500 mg over 3-4 minutes
IV intermittent infusion

Yes for doses < 500 mg

Usual dilution:

  • < 500 mg: 10 mg/mL

Infusion time over 30 minutes

IV continuous infusion No

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

  • Age < 3 months or weight < 4 kg: 25 mg amoxicillin/kg/dose every 12 hours
  • Age > 3 months: 25 mg/kg/dose every 8 hours  Maximum: 1000 mg amoxicillin/dose

Adult:

  • 1000 mg amoxicillin IV every 8 hours

Renal Adjustments:

  • CrCl 10 - 30 mL/min: 25 mg amoxicillin/kg/dose (max 1000 mg) IV every 12 hours
  • CrCl < 10 mL/min: 25 mg amoxicillin/kg/dose (max 1000 mg) IV every 24 hours
  • Hemodialysis: 25 mg amoxicillin/kg/dose (max 1000 mg) IV every 24 hours plus 12.5 mg amoxicillin/kg/dose at the end of dialysis
Potential hazards of parenteral administration: 
  • Local reactions at injection site: pain, phlebitis, inflammation
  • Hypersensitivity reactions - manifested by rash, pruritis, bronchospasm, anaphylaxis
  • Diarrhea, nausea, and vomiting may occur
Notes: 
  • Sodium content: 2.7 mmol per 1000 mg of amoxicillin. 
  • Potassium content: 1 mmol per 1000 mg of amoxicillin

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