Amoxicillin Clavulanate ======================== **PD Dialyzability**: Very likely Pharmacokinetic Parameters [1]_ [2]_ --------------------------- =========================================================================== ============================= ================= \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ Amoxicillin Clavulanate =========================================================================== ============================= ================= Molecular Weight (Da) 364 199 Plasma Protein Binding (%) 15 - 25 22 - 30 Volume of Distribution (L/Kg) 0.26 0.3 [3]_ Hepatic Metabolism <30%, CYP2C19 Yes Excreted Unchanged (%) 50 - 70 30 - 40 Half-Life; Normal Renal Function (hours) 0.9 - 2.3 1 Half-Life; ESRD (hours) 5 - 20 3 - 4 [3]_ =========================================================================== ============================= ================= CAPD Dosing: [2]_ [3]_ [4]_ [5]_ ------------ * Amoxcillin clavulanate 250-500mg PO BID (Note: Dosing of amoxicillin/clavulanate combination is based mainly on the dosing of the amoxicillin portion) CCPD Dosing: --------------- * One study identified. See literature summary below. Literature Summary: --------------------------- +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | Title | Patient | Intervention | Outcome | Note | +========+==================================+==============+============================================================================+===================+ | |L1| | - |P1| | - |I1| | |O1| | |N1| | | [6]_ | - |P2| | - |I2| | | | | | - |P3| | | | | | | - |P4| | | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | |L2| | - |P1| | - |I3| | - |O2| | |N2| | | [7]_ | - |P5| | - |I4| | - |O3| | | | | - |P6| | | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ | |L3| | - |P7| | |I5| | |O4| | |N1| | | [8]_ | - |P8| | | | | | | | - |I6| | | | | | | - |I7| | | | | | | - |I8| | | | +--------+----------------------------------+--------------+----------------------------------------------------------------------------+-------------------+ References --------------- .. [1] Wishart DS, Knox C, Guo AC, Shrivastava S, Hassanali M, Stothard P, et al. DrugBank: a comprehensive resource for in silico drug discovery and exploration. Nucleic Acids Res. 2006 Jan 1;34(Database issue):D668-672. .. [2] American Pharmacists Association. Drug information handbook: a comprehensive resource for all clinicians and healthcare professionals. Hudson, Ohio; [Washington, D.C.: Lexi-Comp ; American Pharmacists Association; 2012. .. [3] Gilbert B, Robbins P, Livornese LL. Use of Antibacterial Agents in Renal Failure. Medical Clinics of North America. 2011 Jul;95(4):677–702. .. [4] Aronoff GR, editor. Drug prescribing in renal failure: dosing guidelines for adults and children. 5. ed. Philadelphia, Pa: American College of Physicians; 2007. .. [5] `Adjusting oral antibiotics to estimated creatinine clearance [Internet]. Vancouver: Vancouver Coastal Health. Clinical Services Unit Pharmaceutical Sciences Vancouver Acute.; 2013 [cited 1 December 2015]. `_ .. [6] Bibashi E, Kokolina E, Mitsopoulos E, Kontopoulou K, Sofianou D. Peritonitis Due to Rothia dentocariosa in a Patient Receiving Continuous Ambulatory Peritoneal Dialysis. Clinical Infectious Diseases. 1999 Mar;28(3):696–696. .. [7] Carlini A, Mattei R, Lucarotti I, Bartelloni A, Rosati A. Kocuria kristinae: an unusual cause of acute peritoneal dialysis-related infection. Perit Dial Int. 2011 Feb;31(1):105–7. .. [8] Aguilera A, Codoceo R, Bajo MA, Diéz JJ, del Peso G, Pavone M, et al. Helicobacter pylori infection: a new cause of anorexia in peritoneal dialysis patients. Perit Dial Int. 2001;21 Suppl 3:S152-156. .. |L1| replace:: Peritonitis due to Rothia dentocariosa in a patient receiving continuous ambulatory peritoneal dialysis. .. |L2| replace:: Kocuria kristinae, an unusual cause of peritonitis in dialysis patients. .. |L3| replace:: Helicobacter pylori infection: A new cause of anorexia in peritoneal dialysis patients. .. |P1| replace:: CAPD .. |P2| replace:: 66 year-old man .. |P3| replace:: History of peritonitis .. |P4| replace:: Admitted for fever and abdominal pain .. |I1| replace:: TMP/SMX 160/800mg PO BID. patient developed thrombocytopenia and leukopenia after 4 days. .. |I2| replace:: therapy switched to amoxi-clav 500/125mg PO TID plus amikacin 250mg IV Q48H for 14 day. .. |O1| replace:: Resolution of symptoms and fever. Catheter removed. Hemodialysis initiated. .. |N1| replace:: No ADR reported .. |P5| replace:: 78 year-old man .. |P6| replace:: Admitted for fever and abdominal pain .. |I3| replace:: Empiric therapy with cefotaxime IP + tobramycin IP + tazobactam IV .. |I4| replace:: Day 6 - therapy adjusted based on C&S: ciprofloxacin IP + teicoplanin IP + amoxi-clav IV 2000mg BID .. |O2| replace:: C&S guided therapy resulted in clinical improvement .. |O3| replace:: Stepped down to ciprofloxacin 750mg po BID x 14 days on discharge (Day 16) .. |N2| replace:: Multiple antibiotic regimens employed .. |P7| replace:: 48 PD patients (CAPD & APD) divided into four groups based on presence of anorexia and H. pylori infection .. |P8| replace:: All given H.pylori treatment to assess impact on malnutrition status .. |I5| replace:: 10 days of: .. |I6| replace:: Omeprazole 40mg PO daily .. |I7| replace:: Clarithromycin 1g PO daily .. |I8| replace:: Amoxicillin/Clavulanate 1000/250mg PO daily .. |O4| replace:: H pylori eradication improved patient’s appetite and nutritional status.