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Co-amoxiclav Intravenous for Adults

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 required dose to 100ml of infusion fluid 
  • A 50ml infusion may be used if required (eg fluid restriction) but the residual volume in the infusion line must be flushed through at the same rate to avoid significant underdosing
  • 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 25° C
  • 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 Fresenius Kabi April 2019

1: GUH Antimicrobial Guidelines Checked April 2022

 2: Uptodate, checked online April 20th 2022

Augmentin, Coamoxiclav (Search term)

Search term: Augmentin

Therapeutic classification

Antibiotic