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Augmentin

Clinical Pharmacology
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Clinical Pharmacology

For Gram-Negative Enteric Aerobes:

MIC (mcg/mL) Interpretation
≤ 8/4 Susceptible(S)
16/8 Intermediate(I)
≥ 32/16 Resistant(R)

For Staphylococcus** and Haemophilus species:

MIC (mcg/mL) Interpretation
≤ 4/2 Susceptible (S)
≥ 8/4 Resistant (R)
**Staphylococci which are susceptible to amoxicillin/clavulanic acid but resistant to methicillin/oxacillin must be considered as resistant.

For S. pneumoniae from non-meningitis sources: Isolates should be tested using amoxicillin/clavulanic acid and the following criteria should be used:

MIC (mcg/mL) Interpretation
≤ 2/1 Susceptible(S)
4/2 Intermediate(I)
≥ 8/4 Resistant(R)

NOTE: These interpretive criteria are based on the recommended doses for respiratory tract infections.

A report of “Susceptible” indicates that the pathogen is likely to be inhibited if the antimicrobial compound in the blood reaches the concentration usually achievable. A report of “Intermediate” indicates that the result should be considered equivocal, and, if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. This category implies possible clinical applicability in body sites where the drug is physiologically concentrated or in situations where high dosage of drug can be used. This category also provides a buffer zone, which prevents small uncontrolled technical factors from causing major discrepancies in interpretation. A report of “Resistant” indicates that the pathogen is not likely to be inhibited if the antimicrobial compound in the blood reaches the concentrations usually achievable; other therapy should be selected.

Standardized susceptibility test procedures require the use of laboratory control microorganisms to control the technical aspects of the laboratory procedures. Standard amoxicillin/clavulanate potassium powder should provide the following MIC values:

Microorganism MIC Range (mcg/mL)
Escherichia coli ATCC 25922 2 to 8
Escherichia coli ATCC 35218 4 to 16
Enterococcus faecalis ATCC 29212 0.25 to 1.0
Haemophilus influenzae ATCC 49247 2 to 16
Staphylococcus aureus ATCC 29213 0.12 to 0.5
Streptococcus pneumoniae ATCC 49619 0.03 to 0.12
† † Expressed as concentration of amoxicillin in the presence of clavulanic acid at a constant 2 parts amoxicillin to 1 part clavulanic acid.

Diffusion Techniques: Quantitative methods that require measurement of zone diameters also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. One such standardized procedure2 requires the use of standardized inoculum concentrations. This procedure uses paper disks impregnated with 30 mcg of amoxicillin/clavulanate potassium (20 mcg amoxicillin plus 10 mcg clavulanate potassium) to test the susceptibility of microorganisms to amoxicillin/clavulanic acid.

Brand Name: Augmentin
Generic Name: Amoxicillin Clavulanate
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