clavulanat

Clavulanat, also known as clavulanic acid, is a beta-lactamase inhibitor used in combination with certain beta-lactam antibiotics to extend their antimicrobial spectrum. It is often administered as a salt, such as potassium clavulanate, and is included in fixed-dose combinations with antibiotics like amoxicillin.

Mechanism of action is based on inhibition of serine beta-lactamases produced by many resistant bacteria. Clavulanat acts as a mechanism-based (suicide) inhibitor, forming a covalent bond with the enzyme and inactivating it. By neutralizing beta-lactamases, clavulanat protects the accompanying antibiotic from enzymatic degradation, allowing it to reach its penicillin-binding targets in bacteria.

Clinical use centers on infections where beta-lactamase production reduces antibiotic efficacy. The most common preparation is amoxicillin-clavulanate, marketed as co-amoxiclav or Augmentin, used for sinusitis, otitis media, pneumonia, skin and soft tissue infections, and intra-abdominal infections. Other combinations include ticarcillin-clavulanate for certain moderate infections.

Pharmacokinetics vary by formulation but clavulanat is generally well absorbed orally and provides systemic exposure when paired with its partner antibiotic. It is partly metabolized by the liver and excreted in urine, with dose adjustments needed in renal impairment.

Adverse effects resemble those of beta-lactam therapy and include diarrhea, nausea, rash, and candidiasis. Allergic reactions can occur in penicillin-sensitive individuals. Clavulanat is not used alone as an antibiotic and should be used with caution in patients with penicillin allergy or significant hepatic impairment.