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探索高剂量阿莫西林克拉维酸钾(1克)在不同临床情况下的治疗潜力:一篇综述。

Exploring the Therapeutic Potential of High Dose Co-amoxiclav (1 gm) in Different Clinical Conditions: A Review.

作者信息

Jena Debasis, Kanti Ghosh Tushar, Pal Amitrajit, Pawar Dattatray, Sharma Akhilesh

机构信息

Otorhinolaryngology (ENT), Srirama Chandra Bhanja (S.C.B. Medical College & Hospital, Cuttack, IND.

Ear, Nose, and Throat, Ghosh ENT Foundation, Kolkata, IND.

出版信息

Cureus. 2024 Jul 17;16(7):e64717. doi: 10.7759/cureus.64717. eCollection 2024 Jul.

Abstract

Amoxicillin/clavulanate (co-amoxiclav) is a widely used antibiotic in community healthcare settings, combining amoxicillin and clavulanate potassium to combat β-lactamase-producing bacteria. Despite its extensive use, limited pharmacokinetic/pharmacodynamic data support current dosing guidelines. This review explores the significance of high-dose co-amoxiclav (875 mg/125 mg) in treating various infections amidst rising antibiotic resistance. A comprehensive narrative literature review was conducted using MEDLINE, PubMed, and Google Scholar, focusing on co-amoxiclav 875 mg/125 mg from 1992 to 2024. Keywords included "Co-amoxiclav 875mg/125mg," "amoxicillin 875mg," "Co-amoxiclav dosing," "pharmacology," "PK," and "safety." Studies on non-safety aspects, those on cost-effectiveness, non-English articles, and those without full-text access were excluded. Clinical efficacy studies demonstrate the effectiveness of co-amoxiclav (875 mg/125 mg) in treating conditions such as cutaneous actinomycosis, actinomycetoma, lower respiratory tract infections, acute bacterial maxillary sinusitis, and community-acquired pneumonia. Comparative studies reveal similar or superior efficacy of co-amoxiclav (875 mg/125 mg) compared to other dosing regimens and antibiotics such as clindamycin, cefaclor, cefuroxime, and ciprofloxacin. Safety and tolerability assessments indicate that co-amoxiclav is generally well-tolerated, with common mild-to-moderate gastrointestinal side effects. In summary, co-amoxiclav 1 gm remains a crucial antibiotic with optimized dosing regimens enhancing clinical outcomes while addressing resistance challenges.

摘要

阿莫西林/克拉维酸(复方阿莫西林)是社区医疗环境中广泛使用的一种抗生素,它将阿莫西林和克拉维酸钾结合起来,用于对抗产β-内酰胺酶的细菌。尽管其使用广泛,但支持当前给药指南的药代动力学/药效学数据有限。本综述探讨了在抗生素耐药性不断上升的情况下,高剂量复方阿莫西林(875毫克/125毫克)在治疗各种感染中的意义。使用MEDLINE、PubMed和谷歌学术进行了全面的叙述性文献综述,重点关注1992年至2024年的875毫克/125毫克复方阿莫西林。关键词包括“复方阿莫西林875毫克/125毫克”、“阿莫西林875毫克”、“复方阿莫西林给药”、“药理学”、“药代动力学”和“安全性”。排除了关于非安全性方面的研究、成本效益研究、非英文文章以及无法获取全文的文章。临床疗效研究表明,复方阿莫西林(875毫克/125毫克)在治疗皮肤放线菌病、放线菌瘤、下呼吸道感染、急性细菌性上颌窦炎和社区获得性肺炎等病症方面有效。比较研究显示,与其他给药方案以及克林霉素、头孢克洛、头孢呋辛和环丙沙星等抗生素相比,复方阿莫西林(875毫克/125毫克)具有相似或更好的疗效。安全性和耐受性评估表明,复方阿莫西林总体耐受性良好,常见轻度至中度胃肠道副作用。总之,1克复方阿莫西林仍然是一种关键抗生素,优化的给药方案可提高临床疗效,同时应对耐药性挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198a/11327957/c0f85d4f6294/cureus-0016-00000064717-i01.jpg

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Amoxicillin and amoxicillin plus clavulanate: a safety review.
Expert Opin Drug Saf. 2009 Jan;8(1):111-8. doi: 10.1517/14740330802527984.
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