The efficacy of amoxycillin/clavulanate (Augmentin) in the treatment of severe staphylococcal infections.

The experimental and clinical values of amoxycillin/clavulanate in severe Staphylococcus aureus infections are reviewed. Experimentally, amoxycillin/clavulanate was highly effective in the treatment of acute endocarditis due to methicillin-sensitive isolates of S. aureus (MSSA) in rats. In addition, high doses of amoxycillin/clavulanate also cured experimental endocarditis due to methicillin-resistant strains of S. aureus (MRSA) in the animal model. In the clinical setting, a review of 86 patients with either community- or hospital-acquired bacteraemia due to MSSA showed that intravenous treatment with amoxycillin/clavulanate was adequate for empirical (and apparently also long-term) therapy of such severe infections. However, the retrospective nature of the analysis did not allow assessment of the relative efficacy of amoxycillin/clavulanate as compared with standard anti-staphylococcal drugs, such as flucloxacillin or vancomycin. Further prospective studies are warranted to address this issue. Thus, amoxycillin/clavulanate appears to be a good candidate for empirical treatment of severe infections that may be caused by MSSA. Usage of amoxycillin/clavulanate against MRSA is, however, still experimental and is not currently advocated for the treatment of MRSA infections in humans.