List of cheap analogues of Augmentin for adults and children and their comparison

Augmentin is a semi-synthetic broad-spectrum antibiotic with a good antibacterial effect.

The main substance of the drug is amoxicillin, active against gram-positive and gram-negative microorganisms, as well as clavulanic acid.

The drug is presented in the form of tablets and powder for preparing a suspension for internal use, as well as powder for diluting an injection solution. The exact dosage of the dosage form and suitable analogues are selected by the doctor individually for each patient.

The drug is recommended for patients with diseases of bacterial etiology that affect the respiratory tract and ENT organs, skin and subcutaneous tissue, the genitourinary system, as well as for the elimination of sepsis, osteomyelitis, phlegmon and peritonitis.

pharmachologic effect

Manufacturer: GlaxoSmithKline plc (UK)
Release form: tablets, powder for solution for intravenous administration, suspension

Active ingredient: amoxicillin, clavulanic acid

Analogs: Amoxiclav, Azithromycin, Flemoxin

Augmentin is an antibacterial agent, active against many strains of gram (+) and gram (-) microorganisms. The drug has the ability to penetrate bacterial cell walls and cause inactivation of enzymes, which leads to the death of pathogens.

List of cheaper structural analogues

The list of exact structural analogues of Augmentin includes all antibacterial drugs from the group of protected penicillins, containing amoxicillin + clavulanic acid.

There are more than forty items in total, but they are more expensive.

More budget-friendly Russian-made generics in tablets are:

• “Amosin” – from 30 rubles.
• “Verklav” – from 65 rubles.
• “Arlet” – from 110 rubles.
• “Ecoball” – from 120 rubles.
• “Ecoclave” – from 160 rubles.

Inexpensive Ukrainian analogues in tablet form: “A-Clav Pharmex”, “Amoxi-Apo-Clav”, “Amoxil-K”, “Amoxicillin + Clavulanic Acid-Pharmex”, “Theraclave-Zdorovye”.

Cheap foreign substitute: “Amoxiclav” - from 123 rubles. Country of origin: Slovenia.

Indications for use of Augmentin

Augmentin is prescribed for infections caused by pathogenic bacteria sensitive to the antibiotic:

1. For infectious processes of the skin and soft tissues.
2. Diseases of the respiratory system (bronchitis, pneumonia, empyema, lung abscess).
3. Infections of the genitourinary system (cystitis, urethritis, pyelonephritis, gonorrhea, endometritis).
4. Diseases of ENT organs (tonsillitis, sinusitis, otitis media).
5. Infections of the musculoskeletal system (osteomyelitis).

The antibiotic is used for septic conditions, peritonitis, and also as a preventive therapy after surgical and diagnostic interventions of various profiles.

Side effects

When using any dosage form, the development of undesirable side reactions is possible:

• Candidiasis of the skin and mucous membranes.
• Leukopenia, hemolytic anemia, prolongation of bleeding.
• Quincke's edema, vasculitis.
• Dizziness, migraines, hyperactivity, seizures, sleep disturbances, increased arousal, anxiety.
• Stool liquefaction, nausea, vomiting, colitis, gastritis, stomatitis, discoloration of tooth enamel.
• Hepatitis, jaundice, increased bilirubin.
• Rash, itching, urticaria, erythema, dermatitis, pustulosis.

Undesirable reactions from the urinary organs are also possible.

Augmentin - instructions for use

According to the instructions for use of Augmentin, the dosage of the medication is calculated individually, taking into account age, weight, and severity of the infection. The standard dose of the drug is: 1 tablet of Augmentin 500 mg + 125 mg 2-3 times a day, for 2 weeks.

According to indications, it is possible to prescribe the medication according to a stepwise scheme, that is, the initial intravenous administration of the drug is subsequently replaced by taking tablets.

How to take Augmentin: before or after meals

The antibiotic Augmentin should be taken immediately before meals or with meals. The tablet is swallowed whole and washed down with a sufficient amount of water. For children, the medication is prescribed in the form of a suspension from 2 months of age.

Dosages

The selection of the optimal dose depends on the dosage form, which is prescribed taking into account the patient’s age and the nature of the disease.
Dosage table

1 tablet of Augmentin 1000 mg (875+125 mg) is equivalent to 11 ml of suspension (400/57 mg).

Augmentin's analogues

The pharmacy chain has a large number of Augmentin substitutes with equivalent indications and therapeutic effects from domestic and foreign manufacturers. These medications are sold in the form of:

• combination drugs;
• synonyms;
• generics.

A wide range of substitute medications allows doctors to cope with infections of any severity as effectively as possible.

Prices for Augmentin analogues vary widely. The pharmaceutical market is represented by domestic and foreign manufacturers.

Table of Augmentin analogs with price and country of origin.

You can buy analogues of Augmentin cheaper or more expensive. Their cost does not affect the result of treatment, but depends on the manufacturer and the composition of the ingredients.

What else can replace Augmentin for an adult, what analogues? You can supplement the list of antibiotics with the following medications:

• Zinnat;
• Tavanik;
• Vilprafkn;
• Klacid;
• Tsifran;
• Biseptol;
• Clarithromycin;
• Tsiprolet;
• Clavamitin;
• Flemoklab solutab;
• Amoxiclav.

Among the many analogues of Augmentin, there are the latest generation medications with a wide spectrum of action and high activity against bacterial pathogens.

Augmentin or Amoxiclav - which is better for an adult, what is the difference

Manufacturer: LEK D. D. (Slovenia)
Release form: tablets

Active ingredient: amoxicillin, clavulanic acid

Both medications have the same active substances and an equivalent mechanism of action. The difference between the drugs lies in the auxiliary ingredients, of which Amoxiclav has more, which can provoke an unwanted allergic reaction.

Augmentin has fewer side effects, and it will be best for children, since the medication is gentler and is approved for use from 3 months. It will be the best for bronchitis and pneumonia for adults and children, as it is safer, well tolerated and can be prescribed for a long time (up to 2 weeks).

Amoxiclav is preferably used for angina, since the drug quickly, within a short time (5–7 days), relieves pathological symptoms.

Which is better Suprax or Augmentin

Suprax is an antibiotic from the group of 3rd generation cephalosporins, which is produced in the form of capsules and granules for the preparation of a suspension for internal use.

It is not an analogue of the original drug either in terms of the active component or in belonging to the same antibacterial group.

The effect of the drug is due to the ability of the active substance to inhibit the synthesis of cell membranes, suppress the production of gram-positive and gram-negative pathogenic microorganisms.

Suprax is recommended for patients diagnosed with:

• Pharyngitis.
• Sinusitis.
• Sore throats.
• Tonsillitis.
• Bronchitis.
• Inflammatory processes in the middle ear.
• Urogenital infections, gonorrhea.

The indications for the use of drugs are similar, but Suprax is a more powerful drug in terms of pharmacological action. The use of the suspension is indicated for patients from six months, while Augmentin can be taken from 3 months.

Suprax is more expensive than Augmentin, but has a more convenient dosage regimen. Its cheaper analogues are described in this article.

Despite all the differences, the list of possible side effects is similar for both medications. In addition to general contraindications, the use of Suprax is not recommended for pseudomembranous colitis.

In case of an overdose of an antibiotic, you should rinse your stomach, cleanse your intestines, and take symptomatic medications recommended by your doctor.

Augmentin or Azithromycin - which is better for pneumonia and bronchitis

Manufacturer: JSC VERTEKS (Russia)
Release form: capsules

Active ingredient: azithromycin

Both drugs have antibacterial activity, but have a different mechanism of action. Azithromycin belongs to the group of macrolides and is the best in the treatment of bronchitis and pneumonia.

The analogue is not excreted from the body for a long time, which creates its high saturation in the blood plasma. The medication successfully relieves pathological symptoms of pneumonia caused by coronavirus.

Augmentin or Flemoxin Solutab – which is better?

Manufacturer: Astellas Pharma Europe BV (Netherlands)
Release form: tablets

Active ingredient: amoxicillin

Flemoxin Solutab and Augmentin contain the same active ingredient. But Augmentin is supplemented with 1 additional active ingredient - clavulanic acid, which makes it a stronger and better antibiotic in the fight against bacterial infection.

Thanks to the combination of 2 active substances, drug therapy allows you to quickly relieve pathological symptoms and reduce the treatment time for infectious diseases.

The principle of selecting a substitute drug

First of all, it may be necessary to change the medicine for economic reasons. Everything is simple here: choose a cheaper analogue that completely copies the composition of Augmentin.

The original antibiotic belongs to the middle price category and its cost is:

• from 260 rub. for tablets;
• from 140 rub. for the suspension.

According to medical statistics, allergies to clavulanic acid occur in more than 8% of the population.

In this case, a medicine is selected that also contains amoxicillin, but with other beta-lactamase inhibitors (sulbactam and tazobactam). Or a single-component antibiotic, only with amoxicillin (for example Flemoxin-Solutab or Azithromycin).

However, the latter is permissible only when the pathogen is not aggressive towards this active substance.

It is not uncommon for a patient to be allergic to amoxicillin itself. In this situation, you will need an antibiotic from a different pharmacological group - for example, the macrolide Suprax.

Augmentin or Sumamed – which is better?

Manufacturer: PLIVA HRVATSKA D.O.O.
(Croatia) Release form: tablets, capsules, powder for suspension

Active ingredient: azithromycin

Both medications have different active ingredients, but an equivalent therapeutic effect. Sumamed will be the best for angina, since only 3 tablets are required per course of treatment. The analogue, after taking it, remains in the body for another 3 days, which makes it possible to reduce or completely eliminate the symptoms of the disease.

For children, the analogue of Augmentin in suspension Sumamed is successfully used to treat bronchitis, otitis, and sore throat.

Augmentin tablets p/o 500 mg. 125 mg No. 7x2

Name

Augmentin tab.co.pl.vol. 500 mg 125 mg per blister pack No. 7x2

Description

Tablets: For a dosage of 500 mg / 125 mg: oval-shaped tablets from white to almost white, film-coated, with the inscription “AC” embossed and a score line on one side. The score allows the tablet to be broken to make it easier to swallow, but is not intended to break the tablet into two equal doses. For 875 mg/125 mg dosage: white to off-white, oval, film-coated tablets with “AC” embossed on both sides of the tablet and a score line on one side of the tablet. The score allows the tablet to be broken to make it easier to swallow, but is not intended to break the tablet into two equal doses.

Main active ingredient

Amoxicillin+clavulanic acid

Release form

pills

Dosage

500mg125mg

pharmachologic effect

Beta-lactam antibiotics-penicillins. Combinations of penicillins, including beta-lactamase inhibitors. ATX code: J01CR02.

Pharmacodynamics

Mechanism of Action Amoxicillin is a semisynthetic penicillin (beta-lactam antibiotic) that inhibits one or more enzymes (known as penicillin-binding proteins) during the biosynthesis of bacterial peptidoglycan, which is a unifying structural component of the bacterial cell wall. Inhibition of peptidoglycan synthesis leads to thinning of the cell wall, which subsequently leads to cell lysis and death. Amoxicillin is destroyed by β-lactamases produced by resistant bacteria, and therefore the spectrum of activity of amoxicillin itself does not include microorganisms that produce these enzymes. Clavulanic acid is a β-lactamase inhibitor, structurally related to penicillins. Clavulanic acid blocks the action of some β-lactamase enzymes, thereby preventing the inactivation of amoxicillin. Clavulanic acid alone does not exhibit a clinically significant antibacterial effect. Pharmacokinetics/pharmacodynamics relationship The main factor determining the effectiveness of amoxicillin is the time at which the minimum inhibitory concentration (T > MIC) is exceeded. Mechanism of formation of resistance There are two main mechanisms of formation of resistance to amoxicillin/clavulanic acid: Inactivation by those beta-lactamases that are not inhibited by clavulanic acid, including beta-lactamases of classes B, C and D. Changes in penicillin-binding proteins, which lead to a decrease in the affinity of the antibacterial agent to given target of action. In addition, changes in the permeability of the microorganism's envelope, as well as the expression of efflux pumps, can cause or contribute to the development of bacterial resistance, especially in Gram-negative bacteria. Bacteriological susceptibility to antibiotics varies regionally and over time. It is advisable to take into account local sensitivity data, especially when it comes to the treatment of severe infections. Experts should be consulted if local resistance data question the effectiveness of the drug for treating certain types of infections. Sensitive microorganisms Aerobic gram-positive microorganisms: Enterococcus faecalis, Gardnerella vaginalis, Staphylococcus aureus, methicillin-sensitive*, coagulase-negative staphylococci (methicillin-sensitive), Streptococcus agalactiae, Streptococcus pneumoniae1, Streptococcus pyogenes and other beta-hemolytic streptococci, group Str eptococcus viridans Aerobic gram-negative microorganisms: Capnocytophaga spp., Eikenella corrodens, Haemophilus influenzae2, Moraxella catarrhalis, Pasteurella multocida Anaerobic microorganisms: Bacteroides fragilis, Fusobacterium nucleatum, Prevotella spp. Microorganisms for which acquired resistance is possible Aerobic gram-positive microorganisms: Enterococcus faecium** Aerobic gram-negative microorganisms: Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris Naturally resistant microorganisms Aerobic gram-negative microorganisms Acinetobacter sp., Citrobacter freundii, Enterobacter sp. , Legionella pneumophila, Morganella morganii, Providencia spp., Pseudomonas sp., Serratia sp., Stenotrophomonas maltophilia Other microorganisms Chlamydophilia pneumoniae, Chlamodophila psittaci, Coxiella burnetii, Mycoplasma pneumoniae * All methicillin-resistant staphylococci are resistant to amoxicillin/clavulanic acid. ** Natural moderate sensitivity in the absence of an acquired resistance mechanism. Amoxicillin/clavulanic acid 875 mg/125 mg and 500 mg/125 mg tablets are not suitable for the treatment of infections caused by penicillin-resistant Streptococcus pneumoniae (see Dosage and Administration and Precautions). In some countries, strains with reduced susceptibility have been reported at frequencies greater than 10%.

Pharmacokinetics

Absorption Amoxicillin and clavulanic acid are completely dissolved in aqueous solutions with a physiological pH value. Both components are quickly and well absorbed from the gastrointestinal tract (GIT) after oral administration. After oral administration, the bioavailability of amoxicillin and clavulanic acid is 70%. The pharmacokinetic parameters of both components are similar, the time to reach maximum plasma concentration (Tmax) is about 1 hour. The following are pharmacokinetic results from a study in which amoxicillin/clavulanic acid tablets (875 mg/125 mg dosage) were administered to healthy volunteers twice daily on an empty stomach and 500 mg/125 mg tablets were administered to healthy volunteers three times daily on an empty stomach. Average value of pharmacokinetic parameters (± relative deviation) Amoxicillin/clavulanic acid Dose (mg) Cmax (mcg/ml) Tmax* (h) AUC (0-24h) (mcg? h/ml) T1/2 (h) Amoxicillin 875 mg /125 mg 875 11.64 ± 2.78 1.50 (1.0-2.5) 53.52 ± 12.31 1.19 ± 0.21 500 mg/125 mg 500 7.19 ± 2.26 1.5 (1.0-2.5) 53.5 ± 8.87 1.15 ± 0.20 Clavulanic acid 875 mg/125 mg 125 2.18 ± 0.99 1.25 (1.0-2 ,0) 10.16 ± 3.04 0.96 ± 0.12 500 mg/ 125 mg 125 2.40 ± 0.83 1.5 (1.0-2.0) 15.72 ± 3.86 0 .98 ± 0.12 *Median (range) Cmax - maximum concentration in blood plasma. Tmax is the time to reach the maximum concentration in the blood plasma. AUC is the area under the concentration-time curve. T1/2 - half-life. Serum concentrations of amoxicillin and clavulanic acid with the combination product are similar to those achieved with equivalent oral doses of amoxicillin or clavulanic acid alone. Distribution 25% of the total amount of clavulanic acid and 18% of amoxicillin are bound to plasma proteins. The volume of distribution is about 0.3-0.4 l/kg amoxicillin and about 0.2 l/kg clavulanic acid. After intravenous administration, both amoxicillin and clavulanic acid are found in the gallbladder, abdominal tissue, skin, adipose and muscle tissue, synovial and peritoneal fluids, bile and purulent discharge. Amoxicillin does not penetrate into the cerebrospinal fluid significantly. In animal studies, no accumulation of drug components was found in any tissues. Amoxicillin, like most penicillins, passes into breast milk. Trace amounts of clavulanic acid are also found in breast milk. Both amoxicillin and clavulanic acid cross the placental barrier. Biotransformation Amoxicillin is partially excreted in the urine as an inactive metabolite of penicillic acid in an amount equivalent to 10-25% of the initial dose. Clavulanic acid undergoes intensive metabolism and is excreted by the kidneys and intestines, as well as in the form of carbon dioxide in exhaled air. Excretion Amoxicillin is eliminated primarily by the kidneys, while clavulanic acid is eliminated by both renal and non-renal mechanisms. The average half-life for the amoxicillin/clavulanic acid combination is approximately 1 hour, and the average total clearance is approximately 25 L/h in healthy volunteers. Approximately 60-70% of amoxicillin and approximately 40-65% of clavulanic acid are excreted unchanged by the kidneys within 6 hours after taking one Augmentin tablet at a dosage of 250 mg + 125 mg or 500 mg + 125 mg. Various studies indicate that 50-85% of amoxicillin and 27-60% of clavulanic acid are excreted by the kidneys within 24 hours. With regard to clavulanic acid, the maximum amount of the active substance is excreted within the first two hours after administration. Concomitant use of probenecid slows down the elimination of amoxicillin, but does not slow down the elimination of clavulanic acid (see section “Interaction with other drugs”). Age The half-life of amoxicillin is similar in children aged three months to two years, as well as in older children and adults. For very young children (including premature infants) in the first week of life, the drug should not be used more than twice a day due to the immaturity of the renal elimination pathway. Because there is an increased likelihood of decreased renal function in elderly patients, caution should be exercised in dose selection. In addition, monitoring of renal function may be required. Gender Oral administration of the amoxicillin/clavulanic acid combination to healthy men and women showed no significant effect of gender on the pharmacokinetics of amoxicillin or clavulanic acid. Renal failure The total serum clearance of amoxicillin/clavulanic acid decreases in proportion to the decrease in renal function. The decrease in drug clearance is more pronounced for amoxicillin than for clavulanic acid, since the majority of amoxicillin is excreted by the kidneys. The drug dosage regimen in patients with renal failure should prevent the accumulation of amoxicillin, while maintaining adequate levels of clavulanic acid. Liver failure The drug should be used with caution in patients with liver failure with constant monitoring of liver function.

Indications for use

Augmentin is indicated for the treatment of the following infections in adults and children: Acute bacterial sinusitis Acute otitis media Exacerbations of chronic bronchitis Community-acquired pneumonia Cystitis Pyelonephritis Skin and soft tissue infections, in particular cellulitis, animal bites, severe dental abscess with spreading cellulitis. Bone and joint infections, in particular osteomyelitis Official guidelines on the rational use of antibacterial agents should be taken into account.

Directions for use and doses

Dosage calculations are based on amoxicillin and clavulanic acid, except in cases where dosing is carried out for each component separately. When selecting a dose, the following factors should be taken into account: likely pathogens and their expected sensitivity to antibacterial drugs (see section "Precautions"); severity and location of infection; age, body weight and renal function status of the patient. If necessary, consider prescribing other dosage forms of Augmentin (including those with a higher amoxicillin content and/or a different amoxicillin/clavulanic acid ratio). The duration of treatment is determined by the clinical picture. Some infections (such as osteomyelitis) require longer treatment. Treatment should not be continued for more than 14 days without reviewing the clinical situation (see section "Precautions"). Adults and children ? 40 kg Recommended dosage regimen: Tablets dosage 875 mg/125 mg Standard dose (for all indications): 875 mg/125 mg twice daily. Higher dose (particularly for infections such as acute otitis media, sinusitis, lower respiratory tract infections, urinary tract infections): 875 mg/125 mg three times daily. Tablets dosage 500 mg/125 mg One tablet (500 mg/125 mg) three times a day. Children mg/kg body weight, see above 12.5-22.5 (up to 35) 1.8 -3.2 (up to 5) 6.67-20 1.67-5 40 kg 21.9 3.1 12.5 3.1 35 kg 25.0 3.6 14.3 3.6 30 kg 29.2 4.2 16.7 4.2 25 kg 35.0 5.0 20.0 5.0 For the treatment of children under 6 years of age inclusive or weighing less than 25 kg, it is preferable to use Augmentin in powder form to prepare a suspension for oral administration in bottles or sachets. Data on the use of dosage forms of the drug Augmentin with a ratio of active components of 7:1 in doses of more than 45 mg/6.4 mg per kg of body weight per day and with a ratio of 4:1 in doses above 40 mg/10 mg per kg of body weight per day in children up to missing for two years. There are no clinical data on the use of dosage forms of Augmentin with a ratio of active components of 7:1 in children under two months of age. Therefore, it is not possible to make dosage recommendations in this group of patients. Elderly patients No dosage adjustment is required. Patients with impaired renal function No dosage adjustment is required if creatinine clearance is more than 30 ml/min. Tablets dosage 875 mg/125 mg In patients with creatinine clearance less than 30 ml/min, it is not recommended to use Augmentin dosage forms with an amoxicillin/clavulanic acid ratio of 7:1, due to the lack of recommendations on the dosage regimen for this group of patients. Tablets 500 mg/125 mg Dosage adjustment is based on the maximum recommended level of amoxicillin. Adults and children ? 40 kg Creatinine clearance 10-30 ml/min: 500 mg/125 mg 2 times a day Creatinine clearance

Use during pregnancy and lactation

Pregnancy Animal studies have not revealed direct or indirect negative effects of the drug on pregnancy, embryonic/fetal development, childbirth or postnatal development. Limited data on the use of amoxicillin/clavulanic acid in women during pregnancy have not shown an increased risk of congenital anomalies. One study in women with premature rupture of membranes found that prophylactic therapy with amoxicillin/clavulanic acid may be associated with an increased risk of necrotizing enterocolitis in newborns. You should avoid taking this medicine during pregnancy unless your doctor considers it necessary. Lactation Both active substances of the drug pass into breast milk (the effect of clavulanic acid on breast-fed children is not known). In this regard, there is a possibility of developing diarrhea or fungal infection of the mucous membranes in breastfed children, so cessation of lactation may be necessary. The possibility of sensitization should be taken into account. The combination of amoxicillin/clavulanic acid can be used during breastfeeding only after a benefit/risk assessment by the attending physician.

Precautionary measures

Before starting treatment with amoxicillin/clavulanic acid, it is necessary to obtain a detailed history regarding previous hypersensitivity reactions to penicillins, cephalosporins or other beta-lactam antibiotics (see sections “Contraindications for use” and “Side effects”). Serious, sometimes fatal, hypersensitivity reactions (including anaphylactoid and severe skin adverse reactions) to penicillins have been described. The risk of such reactions is highest in patients with a history of hypersensitivity reactions to penicillins and in individuals with atopy. If an allergic reaction occurs, treatment with amoxicillin/clavulanic acid should be discontinued and alternative therapy should be initiated. If the infection is confirmed to be due to amoxicillin-susceptible organisms, a switch from amoxicillin/clavulanic acid therapy to amoxicillin therapy should be considered in accordance with official guidelines. Augmentin 875 mg/125 mg and 500 mg/125 mg tablets are not suitable for use in cases where there is a high risk that the suspected pathogens have reduced susceptibility or resistance to beta-lactams that is not mediated by beta-lactamases inhibited by clavulanic acid. These dosage forms should not be used in the treatment of infections caused by penicillin-resistant S. pneumoniae. In patients with impaired renal function or when taking high doses of the drug, seizures may occur (see section "Side effects"). The use of amoxicillin/clavulanic acid is not recommended for suspected infectious mononucleosis, since such patients experience a morbilliform rash after taking amoxicillin. The combined use of allopurinol and amoxicillin increases the risk of allergic skin reactions. Long-term treatment may lead to excessive proliferation of insensitive microorganisms. The appearance of pustules on erythematous areas of the skin with fever at the beginning of treatment may be a symptom of acute generalized exanthematous pustulosis. The occurrence of this adverse reaction requires discontinuation of the drug and is a contraindication to further use of amoxicillin. The combination of amoxicillin/clavulanic acid should be used with caution in patients with signs of liver failure (see sections “Method of administration and dosage”, “Contraindications for use”, “Precautions”). Adverse liver events have been observed primarily in men and elderly patients and may be associated with long-term therapy. These adverse events are very rarely observed in children. Signs and symptoms of liver dysfunction usually occur during or immediately after completion of therapy, but in some cases may not appear until several weeks after completion of therapy. As a rule, they are reversible. Adverse effects from the liver can be severe, and in extremely rare cases there have been reports of death. In almost all cases, these were persons with serious comorbidities or persons receiving concomitantly potentially hepatotoxic drugs. Antibiotic-associated colitis has been reported with virtually all antibacterial agents. This adverse reaction can vary in severity from mild to life-threatening (see section "Side effects"). Therefore, this diagnosis should be considered in patients who develop diarrhea during treatment or after administration of any antibiotics. If antibiotic-associated colitis occurs, the drug should be discontinued immediately. The patient should consult a doctor who will prescribe appropriate treatment. In such a situation, the use of drugs that inhibit peristalsis is contraindicated. During long-term therapy with Augmentin, it is recommended to periodically evaluate renal, liver and hematopoietic function. In patients receiving a combination of amoxicillin and clavulanic acid, prolongation of prothrombin time has been observed in rare cases. When co-prescribing a combination of amoxicillin and clavulanic acid with anticoagulants, appropriate monitoring should be carried out. To maintain the desired level of anticoagulation, dose adjustment of the anticoagulant may be necessary (see section “Interaction with other drugs” and “Side effects”). In patients with impaired renal function, the dose of Augmentin should be adjusted according to the degree of impairment (see section “Dosage and Administration”). In patients with reduced diuresis, the development of crystalluria has been reported in very rare cases, mainly with parenteral use of the drug. While taking high doses of amoxicillin, it is recommended to drink enough fluids and maintain adequate diuresis to reduce the chance of amoxicillin crystal formation. In patients with urinary catheters, catheter patency should be checked regularly (see section "Overdose"). During treatment with amoxicillin, if tests for the presence of glucose in urine are necessary, enzymatic methods for determining glucose oxidase should be used due to the possibility of obtaining a false positive result when using non-enzymatic methods. The presence of clavulanic acid in the drug may cause nonspecific binding of IgG and albumin to red blood cell membranes, which may lead to a false-positive Coombs test result. Patients taking the amoxicillin/clavulanic acid combination may experience a false-positive test result for Aspergillus infection when using the Platelia Aspergillus EIA tests. Cross-reactions between the Platelia Aspergillus EIA test and non-Aspergillus polysaccharides and polyfuranoses have been reported. Therefore, positive test results in patients taking the combination of amoxicillin/clavulanic acid should be interpreted with caution and confirmed by other diagnostic methods.

Interaction with other drugs

Oral anticoagulants: Oral anticoagulants and penicillin antibiotics are widely used in clinical practice without reports of their interaction. However, the literature describes cases of an increase in the international normalized ratio (INR) in patients with the combined use of acenocoumarol or warfarin and amoxicillin. If concomitant use is necessary, the prothrombin time or INR should be carefully monitored when amoxicillin is instituted or discontinued. In addition, dose adjustment of oral anticoagulants may be required. Methotrexate: Penicillins may decrease the excretion of methotrexate, resulting in potential increased toxicity. Probenecid: It is not recommended to use Augmentin simultaneously with probenecid. Probenecid reduces the tubular secretion of amoxicillin, and therefore the simultaneous use of the drug Augmentin and probenecid can lead to a stable and long-term increase in the blood concentration of amoxicillin, but not clavulanic acid. Mycophenolate mofetil: In patients receiving mycophenolate mofetil, after starting the oral combination of amoxicillin and clavulanic acid, a decrease in the concentration of the active metabolite, mycophenolic acid, before taking the next dose of the drug was observed by approximately 50%. Changes in this concentration may not accurately reflect overall changes in mycophenolic acid exposure. In this regard, as a rule, no dose adjustment of mycophenolate mofetil is required in the absence of clinical signs of graft dysfunction. However, careful clinical monitoring should be carried out while taking the combination of drugs, as well as shortly after the end of antibiotic treatment.

Contraindications

Hypersensitivity to any of the components of the drug or penicillins. A history of severe immediate hypersensitivity reaction (eg, anaphylaxis) to prior administration of beta-lactam antibiotics (cephalosporins, carbapenems, or monobactams). A history of jaundice or impaired liver function that developed during the use of a combination of amoxicillin/clavulanic acid (see section “Side effects”).

Compound

Active ingredients: amoxicillin (in the form of amoxicillin trihydrate) 500.0 mg or 875.0 mg, respectively, clavulanic acid (in the form of potassium clavulanate) 125.0 mg. Excipients: tablet core: magnesium stearate, sodium starch glycolate (type A), colloidal anhydrous silicon dioxide, microcrystalline cellulose; tablet shell: titanium dioxide (E171), hypromellose 5 cps, hypromellose 15 cps, macrogol 4000, macrogol 6000, dimethicone. The ratio of active components (amoxicillin/clavulanic acid) is 4:1 (500 mg/125 mg tablets) and 7:1 (875 mg/125 mg tablets).

Overdose

Symptoms and signs Gastrointestinal disturbances and fluid and electrolyte disturbances may occur. Amoxicillin crystalluria has been described, in some cases leading to the development of renal failure (see section "Precautions"). When taking high doses of the drug or in patients with impaired renal function, seizures may occur. There are reports of amoxicillin sedimentation in urinary catheters, mainly after intravenous administration in large doses, so regular checks of catheter patency should be carried out (see section "Precautions"). Treatment Symptomatic correction of gastrointestinal disorders can be carried out, with special attention to the normalization of water and electrolyte balance. Amoxicillin and clavulanic acid can be removed from the bloodstream by hemodialysis.

Side effect

The most common adverse reactions are diarrhea, nausea and vomiting. Adverse events identified during clinical trials and post-marketing surveillance are listed by body system and according to frequency of occurrence. The frequency of occurrence is determined as follows: very often (? 1/10), often (? 1/100 and

Storage conditions

Store at a temperature not exceeding 25°C. Keep out of the reach of children. Store in a dry place in the original packaging to protect from moisture.

Augmentin or Amoxicillin – which is better for adults, what is the difference

Manufacturer: JSC BIOCHIMIC (Russia)
Release form: tablets, capsules

Active ingredient: amoxicillin

Antibiotics of the penicillin group have the same active substance and mechanism of action. The difference between medications can be traced in the composition of additional ingredients. The analogue does not contain glucose and can be used by patients with diabetes.

Augmentin has an additional active component, which makes it superior in the treatment of diseases in adults caused by an unknown pathogen.

Combined substitutes with beta-lactamase inhibitors

In addition to clavulanic acid, beta-lactamase inhibitors include sulbactam and tazobactam.

Combined preparations containing the following substances:

• Ampicillin + Sulbactam OJSC Kraspharma from 130 rub.
• Cephtractam from 30 rubles/ampoule.
• Flemoklav solutab from 231 rub.
• Cefoperazone and Sulbactam Jodas from 2100 rub.
• Tazocin from 6900 rub.
• Piperocilin-tazobactam from RUB 1,351.

If you need to select a replacement, it is recommended to first consult with your doctor, since all antibiotics are available in pharmacies with a prescription.

Ceftriaxone

Manufacturer: ZAO LEKKO (Russia)
Release form: powder for the preparation of a solution for parenteral administration

Active ingredient: ceftriaxone

The medication is a 3rd generation cephalosporin antibiotic. Ceftriaxone has a broad spectrum of action and activity against a wide range of strains of gram-positive and gram-negative bacteria.

The Augmentin analogue inhibits the biosynthesis of the bacterial cell wall. The drug actively penetrates the tissues and fluids of the body, exerting a bactericidal effect.

Azithromycin or Augmentin

Azithromycin is a similar antibacterial drug with a mono composition that can be used as a replacement for Agumentin.

Both drugs have a wide spectrum of action and help provide a bactericidal and bacteriostatic effect.

Comparative characteristics of drugs:

• Indications for use and the possibility of use in childhood are similar for the two antibiotics.
• At the same time, Azithromycin combines worse with other drugs than Augmentin and interacts with antacids and fluconazole-based medications.
• Acithromycin has a slower absorption (up to 3 hours), while with Augmentin this process takes up to 2 hours.
• Amoxicillin does not act against pathogenic microorganisms that produce penicillinase.
• Unlike Augmentin, Azithromycin is a selective component that is released only in the tissues of organs affected by the causative agent of the pathological process.

To avoid the development of unwanted side reactions, the drugs are not taken together. The main difference between Azithromycin is its selectivity, better tolerability, and safety.

Suprax

Manufacturer: Menarini Manufacturing Logis (Italy)
Release form: tablets

Active ingredient: cefixime

Suprax is a semi-synthetic cephalosporin antibiotic. This analogue of Augmentin in tablets has a wide spectrum of action and is a 3rd generation antibiotic.

The medication has a bactericidal effect due to inhibition of the synthesis of the cell membrane of the bacterial pathogen. The drug has a long half-life, which allows you to take the medicine once a day.

Levofloxacin

Manufacturer: OZON LLC (Russia)
Release form: tablets, solution for infusion

Active ingredient: levofloxacin

Levofloxacin is an antibacterial drug of synthetic origin that exhibits activity against a wide range of aerobic and anaerobic microorganisms. This analogue of Augmentin is quickly and almost completely absorbed into the blood after internal use.

The drug has a bactericidal effect due to the inhibition of enzymes responsible for the replication of daughter DNA molecules.

Ampicillin

Manufacturer: JSC SINTEZ (Russia)
Release form: tablets, capsules, powder for the preparation of suspension, solution for intramuscular and intravenous administration

Active ingredient: ampicillin

Ampicillin is a semisynthetic antibiotic of the penicillin series. This analogue of Augmentin has a bactericidal effect on gram-positive and gram-negative microorganisms, inhibiting the biosynthesis of the cell membrane and disrupting peptide bonds in it. The medication does not accumulate in the body after repeated doses of the medication.

A large selection of Augmentin analogues significantly expands the doctor’s capabilities in the fight against infection. A properly prescribed antibiotic will stop the manifestations of infection and prevent the progression of the pathological process and the development of complications.