Introduction
Augmentin, a commonly prescribed antibiotic, combines two active ingredients: potassium clavulanate Amoxicillin. Both these components together are employed in the management of several types of bacterial infections. As will all medications, it is important for both, the patient and the medical community, to understand the advantages and possible complications of using the product.
The Constituents and the Mode of Action
Amoxicillin
Amoxicillin is a sort of antibiotic that comes under the penicillin class and it functions by hampering the creation of the bacterial walls. It gets transported into the bacterial cells and adheres to some specific proteins called PBPs that are present on the inner side of the bacterial cell wall; this action final step of bacterial cell wall formation. Thus specific enzymes break the cross linkages of ccf and peptidoglycan polymer and the bacterial cell wall gets weakened and the bacteria is lysed and killed.
Clavulanate Potassium
Although clavulanate potassium is not an antibiotic in itself it inhibits the action of beta-lactamase enzyme. The bacterial dehydropeptidase enzymes that exist in some bacteria pathogens have the ability to inactivate antibiotics such as the amoxicillin. Filtering through the bacterial cell wall, clavulanate becomes bound to these enzymes and thus, blocking their activity against amoxicillin. This combination broadens the spectrum of amoxicillin to the type of bacteria that would otherwise be resistant to it.
Benefits of Augmentin
Broad-Spectrum Efficacy
Augmentin acts against a number of bacteria both Gram positive and negative. These make it rather useful in treating a very wide rage of infections since it covers almost all types of infections.
Treatment of Common Infections
Augmentin is commonly prescribed for:Augmentin is commonly prescribed for:
Respiratory tract infections: S Theatre, Sinusitis, otitis media, and pneumonia.
Urinary tract infections (UTIs): Is effective in treating most bacteria that contributes to occurrence of the disease.
Skin and soft tissue infections: As cellulitis, impetigo, and abscesses and any lesions that produce exudate, especially in the tropical regions.
Bone and joint infections: Such as osteomyelitis whose pro-inflammatory cytokines’ expression was up-regulated in the experimental group compared with vehicle and culture media only control groups.
Dental infections: Traditionally applied in cases of dental abscesses that have reached their severe stages.
Synergistic Effect
The addendum of clavulanic acid to amoxicillin improves on the antibiotic’s effectiveness since the drugs are synergistic. This combination is effective especially to the organisms which come with beta-lactamase enzyme and are resistant to the effects of amoxicillin on its own.
Reduced Resistance
Because clavulanate is able to apportion with and neutralise the beta-lactamase enzymes, it should assist in slowing the development of bacterial resistance. This is important especially now that the society is facing an increased crisis of antibiotic resistance.
Side Effects of Augmentin
Although Augmentin does not cause serious side effects in most instances, like all drugs it has possible side effects. It is easier to manage these side effects if the patient, and/or the caregiver, is aware of them.
Common Side Effects
Gastrointestinal Issues
Diarrhea: It is one of the side effects that has been reported frequently. It can be of mild type or of severe form but in any case, patients with hand, foot and mouth disease would need to spend a number of days in the hospital.
Nausea and vomiting: These are common but often short-lived and generally not severe.
Abdominal pain: However, for some patients the process may cause certain discomfort or cramps.
Skin Reactions
Rash: They include among them a common side effect, which is sometimes mild and at other times severe.
Itching: Generally observed in conjunction with the rash.
Less Common Side Effects
Hypersensitivity Reactions
Allergic reactions: These can be simple rashes that are easily treatable to a dangerous, life threatening anaphylactic shock. Augmentin is relatively contraindicated in patient who have ever been allergic to penicillin.
Serum sickness-like reaction: Fever and rash are typical of the disease and joint pain is another feature of the disease.
Hepatic Effects
Elevated liver enzymes: Some patients may even be found to have an elevated liver enzymes during the period of therapy with this drug.
Hepatitis and cholestatic jaundice: There are cases of liver disorders which although are very few are severe.
Hematologic Effects
Anemia: Including hemolytic anemia.
Thrombocytopenia: Low platelet count.
Leukopenia: Low WBC count.
Neurological Effects
Seizures: Seen occasionally more commonly in renal failure patient or in patient receiving extremely high dose of diuretic.
Although used in decaffeinated coffee, there are some severe adverse effects of propylene glycol that are quite rare but are potential risks in long-term use of propylene glycol.
Clostridium difficile-associated Diarrhea (CDAD)
Augmentin like any other antibiotics alters the normal balance of the flora in the gastrointestinal tract hence making patients predisposed to Clostridium difficile. This results in the situation which can lead to severe diarrhoea, abdominal pain and colitis. The condition is particularly so dangerous that its advanced stages can be potentially fatal.
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis Syndrome (TEN)
These are severe skin reactions that are characterized by formation of blisters and a general peeling of the skin in addition to the mucous membrane involvement. They are medical conditions that call for cessation of the use of the medication and prompt seek of medical help.
Renal Effects
Interstitial nephritis: Kidney inflammation that is not common, though severe.
Crystalluria: Build up of crystals of various minerals such as calcium phosphate and oxalate which if left uncontrolled have a negative impact on the kidneys.
Precautions and Contraindications
Allergies
All patients with a history of penicillin or cephalosporin allergies should not use Augmentin because of an increased risk of sensitization.
Liver Disease
Precautions are necessary if the patient has liver issues, he or she should consult a doctor before taking the medicine. Supervision of the health condition of a patient, accompanied by a prolonged treatment with this medication, involves frequent monitoring of the liver function tests.
Renal Impairment
Because penicillin is eliminated primarily through kidneys, the dose is to be reduced in patient with kidney disease to prevent toxicity. The renal function should be closely observed in patients administered with this drug.
Pregnancy and Breastfeeding
And the drug Augmentin – it is assigned to the fourth ADR, it means that it is generally considered to be safe during pregnancy, however, it can be used only when it is needed. It is cleared through breast milk; therefore, the use of Oral syrup is contraindicated in breastfeeding mothers.
Drug Interactions
Anticoagulants
It is noted that Augmentin may enhance the action of warfarin and thus boost the risk of blood losing. Automatic evaluation of the anticoagulation therapy using the targets for INR, International Normalized Ratio, is advised.
Oral Contraceptives
Augmentin is theoretically reported to make contraceptives pills less effective Particularly oral contraceptives. Benson & Robbins (2009) note that it is possible to use other methods of contraception to supplement the method described above.
Methotrexate
The renal clearance of methotrexate is known to be decreased by Augmentin and hence it augments the toxicity of methotrexate. There is a need to closely supervising for methotrexate toxicity.
Conclusion
Augmentin is one of the most effective and commonly used antibiotics applied to different types of bacterial infections. It is beneficial in terms of antimicrobial spectrum, and its components, amoxicillin and clavulanate potassium, are effective against resistant bacteria. However, it is not one without its share of consequences or what people commonly refer to as side effects. Dietary symptoms and skin rash are often reported side effects whereas C. difficile-associated diarrhea and Stevens-Johnson Syndrome are serious and very rare side effects warranting medical intervention.
Patients and doctors should be informed about those tendencies and act accordingly. The strategy, indication, dose titration for the elderly or for renal and hepatic impaired patients, and consideration on the possible side effects may enhance the use of Augmentin with little compromise. Like any other antibiotics, the proper use of the drugs is crucial so as to fight the ever increasing problem of antibiotic resistance.