Co-Amoxiclav KAPL Mechanism of Action

Pharmacology: Pharmacodynamics: Amoxicillin is an orally active member of the penicillin family. In amoxicillin the benzyl ring in site change extends the range of antimicrobial activity into the gram-negative bacteria. It is bactericidal for both gram-positive and negative bacteria.
Clavulanate is a β-lactam antibiotic and interacts with β-lactamase, this interaction may lead to enzyme induction, inactivation of the enzyme and hydrolysis of the β-lactam ring is used clinically only in combination with amoxicillin.
Amoxicillin kills bacteria by interfering with the synthesis of the bacteria cell wall. As the lactamase enzyme secreted by the bacteria destroys amoxicillin the drug is ineffective in most staphylococcal infections. As increasing percentage of Salmonella spp., E. coli, Proteus mirabilis, Shigella spp. are not sensitive to amoxicillin. The spectrum of activity of amoxicillin may be extended by the concomitant use of β-lactamase inhibitors such as clavulanic acid. Clavulanic acid has been reported to enhance the activity of amoxicillin, against several species not generally considered sensitive. Clavulanate by itself has little antibacterial activity. However in association with amoxicillin it produces an antibiotic agent of broad-spectrum.
Co-Amoxiclav is bactericidal to a wide range of organisms such as: Gram-positive: Aerobes: *Enterococcus faecalis, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, *Staphylococcus aureus, *Coagulase-negative staphylococci (including Staphylococcus epidermidis), Corynebacterium sp, *Bacillus anthracis, Listeria monocytogenes, Enterococcus faecium, Streptococcus agalactiae, Streptococcus sp.
Anaerobes: Clostridium, Peptococcus spp, Peptostreptococcus.
Gram-negative: Aerobes: *Haemophilus influenzae, *Escherichia coli, *Proteus mirabilis, *Proteus vulgaris, *Klebsiella sp, *Moraxella catarrhalis (Branhamella catharralis), *Salmonella sp, *Shigella sp, Bordetella pertussis, Brucella sp, *Neisseria gonorrhoeae, *Neisseria meningitidis, Vibrio cholerae, *Yersinia enterocolitica, Pasteurella multocida, Gardnerella vaginalis, Helicobacter pylori, Legionella sp.
Anaerobes: *Bacteroides sp (including Bacteroides fragilis), *Fusobacterium sp.
*Including β-lactamase producing strains resistant to ampicillin and amoxicillin.
Infections caused by amoxicillin-susceptible organisms are amenable to Co-Amoxiclav treatment due to its amoxicillin content. Mixed infections caused by amoxicillin-susceptible organisms in conjunction with Co-Amoxiclav-susceptible β-lactamase-producing organisms may therefore be treated with Co-Amoxiclav.
Pharmacokinetics: Amoxicillin is rapidly distributed throughout the body. The volume of distribution is 0.3 lit/kg body weight. Plasma protein binding is around 20%.
Amoxicillin is metabolized to a limited extent to penicilloic acid, which is excreted in the urine. After parenteral administration, 75% is excreted via the kidney in the following 6 hours.