Who can administer
  
                  May be administered by registered competent doctor or nurse/midwife
      
  
        Important information
  
                  
- Penicillin antibiotic
 
- See under 'Dose' for adjustments required in renal impairment
 
- Hepatic events (most frequently cholestatic hepatitis(ref 2)) have been reported, predominantly in males and elderly patients and may be associated with prolonged treatment. Signs and symptoms usually occur during or shortly after treatment but in some cases may not become apparent until several weeks after treatment has ceased.
 
- Search synonym: Coamoxiclav, Augmentin
 
      
  
        Available preparations
  
                  Co-amoxiclav 1.2g vial
Co-amoxiclav 600mg vial
      
  
        Reconstitution
  
                  Water for injection
20mL per 1.2g vial
10mL per 600mg vial
See under storage below regarding maximum storage time after reconstitution
      
  
        Infusion fluids
  
                  Sodium chloride 0.9%
      
  
        Methods of intravenous administration
  
                  Can use either method of administration- choice depends on practicalities such as time available, fluid status of patient, etc.
Slow intravenous injection (all doses)
- Administer over 3 to 4 minutes
 
Intermittent intravenous infusion (all doses) 
- Add 1.2g to 100mL of infusion fluid
 
- Add 600mg to 50mL of infusion fluid
 
- Administer over 30 to 40 minutes
 
      
  
        Dose in adults
  
                  Usual dose
- Give 1.2g every eight hours
 
Renal impairment (ref 1)
| eGFR (ml per minute/1.73m2) | 
Dose | 
Frequency | 
| less than 30 | 
1.2g | 
every 12 hours | 
| Renal replacement therapy | 
Consult pharmacy/specialist literature | 
Hepatic impairment: Use with caution in hepatic impairment, monitor hepatic function
      
  
        Further information
  
                  
- The dose is expressed in terms of the sum of amoxycillin and clavulanic acid content e.g. 1.2g co-amoxiclav = 1g amoxicillin and 200mg clavulanic acid.
 
      
  
        Storage
  
                  
- Store below 250C
 
- Reconstituted solutions for injection should be administered within 15 minutes after reconstitution
 
- The time interval between the beginning of reconstitution and the end of intravenous infusion should not exceed one hour
 
      
  
        References
  
                  SPC Fresenium Kabi September 2023
1:GUH Antimicrobial Guidelines Checked Oct 2024
2: Uptodate, checked online Oct 2024
Augmentin, Coamoxiclav (Search term)
Search term: Augmentin
      
  
        Therapeutic classification
  
                  Antibiotic