Amoxicilina/Clavulanato de potasio
Amoxicillin/Clavulanate Potassium
Amoxicillin trihydrate and Clavulanate potassium
También conocido como: Clavamox · Augmentin · Amoclan · amoxycillin · p-hydroxyampicillin · BRL 2333 · clavulanic acid · BRL-14151K · kalii clavulanas
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia posológica v13 auditada
Evidencia estructurada para el cálculoSporadic bacterial cystitis (extra-label)
- q8-12h
NA
Contexto clínico obligatorio (3)
- NOTE: All dosages listed are for combined quantities of both drugs (unless otherwise noted).
- ■ This medicine can be given with or without food, but gastrointestinal side effects might be prevented if this medicine is given with food.
- Clavulanate products should be stored at temperatures below 25°C (77°F), and some tablet formulations specify storage at 20°C to 25°C (68°F-77°F). Potassium clavulanate is very susceptible to moisture and should be protected from excessive humidity.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La amoxicilina/clavulanato (conocida comúnmente por el nombre comercial veterinario Clavamox®) es un antibiótico aminopenicilina potenciada de amplio espectro y alta eficacia.
- Espectro ampliado: La adición de ácido clavulánico, un inhibidor de la beta-lactamasa, protege a la amoxicilina de la degradación enzimática, ampliando significativamente su espectro para incluir muchas bacterias productoras de beta-lactamasa (p. ej., Staphylococcus spp., E. coli).
- Utilidad clínica: Está aprobado por la FDA para su uso en perros y gatos en casos de infecciones del tracto urinario (ITU), infecciones de la piel y tejidos blandos, y enfermedad periodontal.
- Elección empírica: Se considera una excelente opción empírica de primera línea para la cistitis bacteriana en perras y, cuando se combina con una fluoroquinolona, para infecciones hepatobiliares.
- Limitaciones: Generalmente no es eficaz contra Pseudomonas aeruginosa o especies de Enterobacter, las cuales a menudo producen cefalosporinasas de tipo I que el ácido clavulánico no puede inhibir.
Mecanismo de acción
Amoxicillin is a time-dependent, bactericidal antibiotic that binds to Penicillin-Binding Proteins (PBPs) → inhibits bacterial cell wall peptidoglycan cross-linking → compromises cell wall integrity → cell lysis and death.
Clavulanic acid acts as a "suicide inhibitor" by competitively and irreversibly binding to beta-lactamase enzymes (types II, III, IV, V, and staphylococcal penicillinases) → prevents the enzymatic destruction of amoxicillin → restores and expands the antimicrobial spectrum against resistant organisms.
Note: There is little synergistic activity against organisms already susceptible to amoxicillin alone.
Seguridad y advertencias
Contraindicaciones
- Patients with a history of hypersensitivity to penicillins
- Small hindgut fermenters (rabbits, guinea pigs, chinchillas, hamsters) due to risk of fatal clostridial enterotoxemia
- Oral administration in patients with septicemia, shock, or grave illness (due to delayed/diminished GI absorption)
Efectos adversos
- Gastrointestinal upset (anorexia, vomiting, diarrhea)
- Hypersensitivity reactions (rashes, fever, eosinophilia, anaphylaxis)
- Antibiotic-associated diarrhea and superinfections (due to altered gut flora)
- Neurotoxicity (e.g., ataxia in dogs) at very high doses or prolonged use
- Elevated liver enzymes (rare)
- Tachypnea, dyspnea, edema, and tachycardia (rarely reported in dogs)
Precauciones
WARNING FOR EXOTIC PETS: Do not administer penicillins to rabbits, guinea pigs, chinchillas, or hamsters, as severe enteritis and fatal clostridial enterotoxemia may occur.
- Cross-Reactivity: Use cautiously in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., cephalosporins, carbapenems).
- Critically Ill Patients: Avoid oral administration in patients in shock or with septicemia due to unreliable gastrointestinal absorption.
- Laboratory Interference: May cause false-positive urine glucose determinations when using cupric sulfate solutions (e.g., Clinitest®).
Interacciones farmacológicas
Theoretical in vitro antagonism; clinical importance is currently in doubt but historically not recommended to combine.
Amoxicillin may decrease the renal excretion of methotrexate, causing increased levels and potential toxic effects.
Competitively blocks the tubular secretion of most penicillins, thereby increasing serum levels and serum half-lives.
In vitro inactivation can occur if mixed together; serum concentrations of aminoglycosides may be falsely decreased if stored prior to analysis.
Monitorización
- Clinical efficacy (resolution of infection signs)
- Adverse gastrointestinal signs (vomiting, diarrhea, anorexia)
Farmacocinética
Vida media
Absorción
Clavulanate potassium is relatively stable in the presence of gastric acid and is readily absorbed. Peak levels occur about 1 hour after dosing.
Distribución
Clavulanic acid has an apparent volume of distribution of 0.32 L/kg in dogs. Distributes (with amoxicillin) into lungs, pleural fluid, and peritoneal fluid. Low concentrations in saliva, sputum, and uninflamed CSF. Readily crosses the placenta and is found in milk in low concentrations. 13% bound to proteins in dog serum.
Metabolismo
Clavulanic acid is extensively metabolized in the dog primarily to 1-amino-4-hydroxybutan-2-one.
Eliminación
Excreted unchanged in the urine via glomerular filtration. In dogs, 34-52% is excreted in urine, 25-27% in feces, and 16-33% into respired air.
Sobredosis
Acute oral penicillin overdoses are unlikely to cause significant problems other than gastrointestinal distress (vomiting, diarrhea, anorexia).
In humans, very high dosages of parenteral penicillins, especially in patients with underlying renal disease, have induced Central Nervous System (CNS) effects. Treatment of oral overdose should be supportive and symptomatic.
Productos disponibles
Formulaciones
- Oral tablets
- Chewable tablets
- Powder for oral suspension
Veterinario
- Oral Tablets (4:1 ratio): 62.5 mg (50 mg amoxicillin/12.5 mg clavulanic acid), 125 mg, 250 mg, 375 mg (Clavamox Tablets®)
- Powder for Oral Suspension: 50 mg amoxicillin/12.5 mg clavulanic acid per mL in 15 mL dropper bottles (Clavamox Drops®)
Etiquetado para humanos
- Tablets: 250 mg/125 mg, 500 mg/125 mg, 875 mg/125 mg (Augmentin®)
- Chewable Tablets: 125 mg/31.25 mg, 200 mg/28.5 mg, 250 mg/62.5 mg, 400 mg/57 mg (Augmentin®)
- Powder for Oral Suspension: Various strengths including 125 mg/31.25 mg per 5 mL, up to 600 mg/42.9 mg per 5 mL (Augmentin®, Amoclan®)
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store clavulanate products at temperatures less than 24°C (75°F) in tight containers, protected from excessive humidity. After reconstitution, veterinary oral suspensions are stable for 10 days when refrigerated (discard unused portions after 10 days). If kept at room temperature, suspensions are stable for only 48 hours.
Información para el cliente
- Administración: Puede administrar este medicamento con o sin comida. Sin embargo, si su mascota presenta malestar estomacal (vómitos o pérdida de apetito), administrar la dosis con una pequeña cantidad de comida o un premio puede ayudar.
- Almacenamiento del líquido: Si utiliza la suspensión oral líquida, es mejor mantenerla en el refrigerador. Deseche cualquier líquido no utilizado después de 10 días, ya que pierde su eficacia.
- Finalización del tratamiento: Siempre termine el tratamiento completo según las indicaciones de su veterinario, incluso si su mascota parece estar completamente recuperada. Suspender el tratamiento antes de tiempo puede provocar infecciones resistentes.
- Efectos secundarios: Puede ocurrir diarrea leve o vómitos. Comuníquese con su veterinario si estos signos se vuelven graves o si su mascota deja de comer.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.