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아목시실린/클라불란산

Amoxicillin/Clavulanate Potassium

Amoxicillin trihydrate and Clavulanate potassium

항생제 - 강화 아미노페니실린PO개고양이페렛새

다른 이름: Clavamox · Augmentin · Amoclan · amoxycillin · p-hydroxyampicillin · BRL 2333 · clavulanic acid · BRL-14151K · kalii clavulanas

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

감사 완료 v13 용량 근거

구조화 용량 계산 근거

Sporadic bacterial cystitis (extra-label)

12.5–25 mg/kgPO
  • q8-12h

NA

반드시 함께 고려할 임상 맥락 (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.
formulary프로토콜 2023감사 dose-audit-plumb-v13

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개요

아목시실린/클라불란산(수의학에서 주로 ​Clavamox®​라는 상품명으로 알려짐)은 매우 효과적이고 광범위한 ​강화 아미노페니실린​ 항생제입니다.

  • ​항균 스펙트럼 확장:​ 베타락타마제 억제제인 클라불란산이 추가되어 효소 분해로부터 아목시실린을 보호하며, 베타락타마제 생성 세균(예: 포도상구균, 대장균)을 포함하도록 항균 범위를 크게 확장합니다.
  • ​임상적 유용성:​ 개와 고양이의 요로 감염(UTI), 피부 및 연부 조직 감염, 치주 질환 치료용으로 FDA 승인을 받았습니다.
  • ​경험적 선택:​ 암컷 개의 세균성 방광염에 대한 훌륭한 1차 경험적 치료제이며, 플루오로퀴놀론과 병용 시 간담도 감염에도 사용됩니다.
  • ​한계:​ 클라불란산이 억제할 수 없는 제1형 세팔로스포리나제를 주로 생성하는 ​녹농균(Pseudomonas aeruginosa)​이나 ​엔테로박터(Enterobacter)​ 종에는 일반적으로 ​효과가 없습니다​.

작용 기전

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.​

안전성·주의사항

금기사항

  • 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)

부작용

  • 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)

주의

​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®).

약물 상호작용

Bacteriostatic Antimicrobials (e.g., chloramphenicol, macrolides, tetracyclines, sulfonamides)

Theoretical in vitro antagonism; clinical importance is currently in doubt but historically not recommended to combine.

Methotrexate

Amoxicillin may decrease the renal excretion of methotrexate, causing increased levels and potential toxic effects.

Probenecid

Competitively blocks the tubular secretion of most penicillins, thereby increasing serum levels and serum half-lives.

Aminoglycosides

In vitro inactivation can occur if mixed together; serum concentrations of aminoglycosides may be falsely decreased if stored prior to analysis.

모니터링

  • Clinical efficacy (resolution of infection signs)
  • Adverse gastrointestinal signs (vomiting, diarrhea, anorexia)

약동학

반감기

개0.39 hours (absorption half-life)

흡수

Clavulanate potassium is relatively stable in the presence of gastric acid and is readily absorbed. Peak levels occur about 1 hour after dosing.

분포

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.

대사

Clavulanic acid is extensively metabolized in the dog primarily to 1-amino-4-hydroxybutan-2-one.

배설

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.

과다투여

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.

제품

제형

  • Oral tablets
  • Chewable tablets
  • Powder for oral suspension

동물용의약품

  • 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®)

인용의약품

  • 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®)

규제 현황

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보관·안정성

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.

보호자 정보

  • ​투여 방법:​ 이 약은 식사와 관계없이 투여할 수 있습니다. 하지만 반려동물이 위장 장애(구토 또는 식욕 부진)를 겪는 경우, 소량의 음식이나 간식과 함께 먹이면 도움이 될 수 있습니다.
  • ​물약 보관:​ 경구용 현탁액(물약)을 사용하는 경우 냉장 보관하는 것이 가장 좋습니다. ​효과가 떨어지므로 10일이 지난 남은 약은 폐기하십시오​.
  • ​치료 완료:​ 반려동물이 완전히 나아진 것 같더라도 항상 수의사의 지시에 따라 처방된 약을 끝까지 먹이십시오. 일찍 중단하면 내성균 감염이 발생할 수 있습니다.
  • ​부작용:​ 가벼운 설사나 구토가 발생할 수 있습니다. 이러한 증상이 심해지거나 반려동물이 먹이를 거부하면 수의사에게 연락하십시오.

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