AUGMENTIN 1GM TABLETS 14S

Augmentin 1g tablets contain amoxicillin 875 mg combined with clavulanic acid 125 mg. Amoxicillin is a broad-spectrum aminopenicillin antibiotic that kills bacteria by inhibiting cell wall synthesis. Clavulanic acid is a beta-lactamase inhibitor; it irreversibly inactivates bacterial beta-lactamase enzymes that would otherwise destroy amoxicillin. This combination restores and extends amoxicillin's spectrum of activity against beta-lactamase-producing organisms.

Augmentin 1g is the adult high-dose formulation and is among the most widely prescribed antibiotics for community-acquired infections in Kenya. It is effective against a broader range of resistant organisms than plain amoxicillin, making it useful for infections that have failed plain amoxicillin, recurrent infections, or infections with a high probability of beta-lactamase-producing pathogens.

Approved uses

•       Lower respiratory tract infections: community-acquired pneumonia, acute exacerbation of COPD, bronchitis

•       Acute otitis media (ear infection) in adults

•       Acute sinusitis

•       Urinary tract infections (complicated or recurrent) including pyelonephritis

•       Skin and soft tissue infections including animal/human bites

•       Dental infections, including dentoalveolar abscess

•       Gynaecological infections

•       Post-surgical prophylaxis and treatment

General Instructions

Take Augmentin 1g at the start of a meal to improve tolerability and reduce gastrointestinal side effects. Swallow tablets whole with water. Do not crush or break unless directed. Space doses evenly throughout the day.

Dosage, Adults

Standard adult dose: one 1g tablet twice daily (every 12 hours) for 5–14 days depending on infection type and severity. For severe infections, the prescriber may adjust.

Elderly Patients

No routine dose adjustment required; monitor for renal impairment (dose reduction if eGFR < 30 mL/min based on amoxicillin component).

Missed Dose

Take the missed dose as soon as remembered unless the next dose is within 6 hours. Do not double up.

Duration of Treatment

Complete the full prescribed course. Duration varies: sinusitis/otitis (5–7 days); UTI (7–10 days); pneumonia (7–14 days); skin infections (5–7 days). Do not stop early even if symptoms improve.

Common Side Effects

•       Diarrhoea, most common side effect; take with food to reduce

•       Nausea and vomiting

•       Abdominal pain and indigestion

•       Skin rash (non-allergic maculopapular rash)

Less Common Side Effects

•       Vaginal or oral thrush (candidiasis), disruption of normal flora

•       Headache

•       Raised liver enzymes

•       Flatulence

Serious / Seek Immediate Medical Attention

•       Anaphylaxis, severe penicillin allergy with throat swelling, collapse, difficulty breathing, EMERGENCY

•       Cholestatic jaundice and hepatitis (clavulanate-associated; may occur weeks after stopping)

•       Clostridium difficile-associated diarrhoea (CDAD), watery/bloody stool, fever; stop and seek care

•       Stevens-Johnson syndrome / TEN (rare)

•       Always document prior penicillin allergy history before dispensing.

•       Clavulanate has a higher rate of hepatotoxicity than amoxicillin alone, monitor liver function if course exceeds 14 days or repeated courses are given.

•       In Kenya, be aware of high amoxicillin resistance rates in E. coli, request culture and sensitivity for complicated UTIs rather than assuming empirical coverage.

•       Reduce dose in significant renal impairment: if eGFR < 30 mL/min, do not use the 875/125 mg formulation; switch to 500/125 mg and extend dosing interval.

•       Prolonged treatment may cause superinfection with Candida or C. difficile.

•       False-positive Coombs test may occur with high-dose amoxicillin-clavulanate.

•       Pregnancy Category B, considered safe when clinically indicated.

Always inform your pharmacist and prescriber about all medicines, supplements, and herbal remedies you are currently taking.

Warfarin / anticoagulants: May potentiate anticoagulant effect, monitor INR

Methotrexate: Penicillins reduce renal tubular secretion of methotrexate, methotrexate toxicity risk

Oral contraceptives: Possible reduced contraceptive efficacy, advise barrier methods during and for 7 days after course

Probenecid: Increases amoxicillin plasma levels by blocking renal secretion, occasionally used therapeutically

Allopurinol: Increased incidence of rash

Mycophenolate mofetil: Antibiotics reduce enterohepatic recirculation of MMF, may reduce immunosuppressive efficacy

Store below 25°C in a cool, dry place away from direct sunlight. In Kenyan conditions, consider refrigeration if ambient temperature regularly exceeds 25°C. Keep in original packaging. Protect from moisture. Keep out of reach of children.

Augmentin is a Prescription Only Medicine (POM) in Kenya. Pharmily strictly requires a valid prescription before dispensing. The Antimicrobial Resistance National Action Plan (NAP) Kenya recommends dispensing antibiotics only against confirmed prescription to preserve efficacy.

Augmentin 1g is the highest-strength oral amoxicillin-clavulanate formulation and carries a meaningfully higher GI side-effect profile than the 625 mg formulation due to the larger clavulanate dose per tablet. Taking with food is non-negotiable for GI tolerance.

The clavulanate component is the source of most hepatotoxicity associated with amoxicillin-clavulanate, the risk increases with longer courses and repeat exposure. If a patient reports previous jaundice or hepatitis with Augmentin, do not dispense without clarification from the prescriber. Cholestatic hepatitis from Augmentin can occur 1–6 weeks after completing the course and is more common in older males, this is relevant when counselling.

In empirical treatment of UTIs in Kenyan women, escalating resistance rates mean that culture and sensitivity is strongly preferred before prescribing Augmentin for anything beyond a first uncomplicated UTI.

What is the difference between Augmentin 1g and plain Amoxil?

A: Augmentin 1g contains amoxicillin plus clavulanic acid. Clavulanic acid blocks the enzymes (beta-lactamases) that many bacteria use to destroy amoxicillin. This makes Augmentin effective against resistant bacteria that would not respond to plain Amoxil.

Why should I take Augmentin with food?

A: The clavulanic acid in Augmentin irritates the stomach lining and causes diarrhoea and nausea if taken on an empty stomach. Taking it at the start of a meal reduces these side effects by up to 50%.

I am allergic to penicillin, can I take Augmentin?

A: No. Augmentin contains amoxicillin, which is a penicillin-type antibiotic. If you are allergic to penicillin, you must not take Augmentin. Inform your doctor or pharmacist so they can prescribe a suitable alternative.

My symptoms are better after 3 days, can I stop taking Augmentin?

A: No. You must complete the full prescribed course, even if you feel better. Stopping early allows surviving bacteria to multiply and develop resistance. The remaining bacteria are often the harder-to-kill ones.

Can I drink alcohol while taking Augmentin?

A: Alcohol is not strictly contraindicated with amoxicillin-clavulanate, but it can worsen nausea and diarrhoea, and may impair recovery from infection. It is best to avoid or minimise alcohol during antibiotic treatment.