Augmentin in pregnancy: dosage and reviews

For a woman who wants to become a mother, the issue of planning a pregnancy after taking antibiotics is relevant. Even if this antibiotic is Augmentin, which is considered relatively safe and is prescribed by doctors to women expecting a child. Perhaps this is why women planning a pregnancy in the near future choose this drug when it is necessary to treat with antibacterial drugs.

Augmentin when planning pregnancy

Official medicine recommends that after an illness that necessitates taking antibiotics, one should use contraception for at least three months and only then try to get pregnant. This is argued by the fact that when an antibiotic enters the systemic bloodstream, it has a negative effect on all human organs, including gametes (sex cells) of both women and men.

Let's try to understand this issue. Female gametes (eggs) are not renewed, they are laid in the female embryo by the end of the first trimester of pregnancy, their number decreases over time, but new ones do not appear. Therefore, the supply of ovum is affected by all unfavorable factors, including antibiotics, which not only the woman but also the mother pregnant with her encountered. There is no need to be afraid, but this fact must be taken into account.

Amoxicillin is a penicillin antibiotic, the active ingredient of Augmentin, which has a range of side effects. Even if no external adverse effects were noticed, the condition of the internal organs of the expectant mother after a serious illness that required antibiotic therapy requires some rehabilitation period, since during the period of bearing a child the load on all the woman's organs will increase. A course of treatment with any antibiotics increases the risk of miscarriage if pregnancy occurs immediately after therapy.

Three months of rehabilitation will be quite enough for the mother's body to get stronger after the disease and drug therapy. In extreme cases, it is recommended to skip at least one menstrual cycle. The goal of the recovery period is to normalize the balanced natural biocenosis of the intestine and the body's immune defense.

By the way, if the future father has undergone a course of antibiotic therapy, then it is also appropriate to observe a three-month interval before conception. During this time, male gametes (spermatozoa) will be completely renewed.

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Can Augmentin be used during pregnancy?

The official instructions for the drug state that it is not recommended to use Augmentin to treat pregnant women, especially in the first three months, when almost all organs and systems of the future child’s body are being formed.

The active ingredients of this drug penetrate the placental barrier. And although there is no data on its teratogenicity, this does not mean that it will not affect the development and health of the baby. The consequence of taking Augmentin may be inflammation of the inner wall of the intestine (necrotizing enterocolitis) in a newborn - the most common cause of a postnatal critical situation.

The exception is cases of extreme necessity. And which case should be considered as such, the doctor should decide, and partly the expectant mother herself will be able, having assessed her condition, to decide what will bring more benefit to her and her child. No one is immune from the side effects listed below, and penicillin drugs (which include Augmentin) are among the most common drug allergens. In addition to allergic reactions, the most common complications of antibiotic therapy in pregnant women are candidiasis of the skin and mucous membranes. Therefore, before you take the first pill or prepare the Augmentin suspension, think carefully.

Indications augmentin in pregnancy

This medicine is prescribed when a local or systemic infection occurs (respiratory organs, genitourinary organs, epithelium and soft tissues) with bacteria sensitized to its active substance.

It has a fairly wide range of activity, but a pregnant woman must determine the susceptibility of the microorganisms that caused her illness to Augmentin, and also do an allergy test to this drug.

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Release form

Available in the following dosage forms:

• tablets containing active ingredients (amoxicillin/clavulanic acid, mg): 500g/125, 875/125; prolonged action – 1000/62.5 mg;
• sachets of powder for making a suspension containing active ingredients in dosages per 5 ml of finished suspension (amoxicillin/clavulanic acid, mg): 200/28.5; 400/57; as well as a 100 ml bottle with a measuring spoon - for making suspension-forte 600/42.9;
• powder packaged in vials for the preparation of an injection solution containing active ingredients (amoxicillin/clavulanic acid, mg): 500/100; 1000/200.

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Pharmacodynamics

The active ingredient of this drug is Amoxicillin. It is a semi-synthetic antibiotic of the penicillin series, to which many gram-positive and gram-negative bacteria are sensitive. Amoxicillin in this drug is potentiated by Clavulanic acid, which prevents its breakdown from the action of ß-lactamase enzymes and, accordingly, increases the range of its antibacterial activity. Due to this composition, Augmentin is able to neutralize ß-lactamase enzymes produced by bacilli resistant to penicillin and cephalosporin drugs. In addition, it exhibits activity against plasmid ß-lactamases, which often cause cross-resistance to antibiotics. Clavulanic acid also has its own bactericidal properties.

The list of microorganisms provided is classified according to sensitization to the drug, established in laboratory conditions:

• gram-positive aerobic bacteria: causative agents of anthrax and listeriosis, enterococci (faecalis, faecium), staphylococci - golden, coagulase-negative (including epidermal), group B streptococci, ß-hemolytic group A, pneumococci and some others;
• gram-positive anaerobic bacteria: clostridia, peptococci, peptostreptococci;
• gram-negative aerobic bacteria: whooping cough bacillus, brucella, Escherichia coli, gardnerella vaginalis, Pfeiffer bacillus, Helicobacter, gonococci, meningococci, pasteurella, some types of Klebsiella and Legionella, cholera vibrio, Yersinia enterocolitica, some Proteus, Salmonella, Shigella and others;
• Gram-negative anaerobic bacteria: some species of Bacteroides and Fusobacteria;
• other microorganisms: spirochete Borrelia (the causative agent of Lyme disease), some types of chlamydia, lertospira, treponema.

Pharmacokinetics

The active ingredients of this medicine when taken orally are well and quickly absorbed by the tissues of the gastrointestinal tract, absorption is improved if you combine the intake of oral forms of Augmentin with the start of a meal. Therapeutic concentrations of its active ingredients are detected in the tissues of the respiratory system, digestion, genitourinary system, muscles, skin, as well as in interstitial fluids. The level of binding of the active components of the drug to plasma proteins is low: clavulanate - 25% of the total concentration in plasma, amoxicillin - 18%.

Animal studies show that the active components of Augmentin do not tend to accumulate in tissues, they penetrate the placental barrier and are found in breast milk. Their teratogenic properties have not been detected.

Approximately three-quarters of the administered amoxicillin is eliminated by the kidneys during the first six hours of a single oral dose of the drug. Clavulanate is excreted in the urine during the same time - up to 65%, its metabolites - in the urine and feces, as well as in exhaled air.

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Dosing and administration

The first three months of pregnancy determine the formation of all vital organs of the future child, so taking antibiotics during this period is strictly prohibited. Augmentin is not prescribed in the first trimester of pregnancy.

From the third to the sixth month of pregnancy, the body's systems are being formed; augmentin can already be prescribed in the 2nd trimester of pregnancy if necessary. It is believed that at this stage of fetal development, the drug can no longer cause significant harm.

From the seventh to the ninth month, the body develops and organs begin to function. Augmentin is probably the safest to take in the 3rd trimester of pregnancy.

The dosage of the drug for a pregnant woman should be prescribed by a doctor, based on the severity of clinical manifestations. The minimum duration of treatment with Augmentin is five days, if necessary, it can be continued, but not more than two weeks.

Augmentin is usually dosed at 625 mg (500 mg amoxicillin and 125 mg clavulanic acid) every eight hours or 1000 mg (875 amoxicillin and 125 mg clavulanic acid) every twelve hours. Such doses are used in the treatment of acute bacterial ENT infections, pneumonia, cystitis, pyelonephritis, diagnosed exacerbation of chronic bronchitis, skin and soft tissue abscesses, joint and bone infectious diseases.

Pregnant women are advised to take the drug in suspension form, since the liquid form is considered less aggressive. The doctor calculates the dosage and frequency of administration based on the woman's condition, since the suspension is intended for children and the dosage of amoxicillin in it is lower.

In principle, it is permissible to take any dosage form, the main thing is to dose the active substance correctly in order to achieve the therapeutic effect as quickly as possible.

You can also use prolonged forms of the drug (once a day), and combine tablets with suspension. However, the dosage is prescribed only by a doctor individually, and self-prescribing the drug or independently changing its form for a pregnant woman is unacceptable. With the correct dosage of Augmentin, the therapeutic effect occurs approximately on the third day, but it is necessary to drink the drug for at least five days. During this time, pathogenic microflora must be destroyed. This is especially important for a pregnant woman, since bacteria that are not completely destroyed can cause a relapse of the disease, and it will have to be treated again.

Most often, pregnant women are treated with antibiotics when they are diagnosed with purulent tonsillitis. Women expecting a child must undergo a test in a bacteriological laboratory to determine the strain of the causative bacteria so that the prescribed treatment is as effective as possible. Purulent tonsillitis is usually caused by streptococcal or staphylococcal infection. Treatment of tonsillitis with Augmentin during pregnancy is justified, since this drug is active against these pathogens and is considered safe for the unborn child.

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Contraindications

Sensitization to one or more ingredients of the drug, penicillin antibiotics, ß-lactams (cephalosporins, carbapenems, monobactams), toxic liver reactions to the active components of the drug, infectious mononucleosis.

Side effects augmentin in pregnancy

Undesirable effects from the drug, especially those that occur in a pregnant woman, are doubly undesirable, as they will require additional treatment.

Very often, treatment with tablets leads to diarrhea, somewhat less often, stomach upset appears as a consequence of therapy with suspension or injections. Often, especially when using high doses, nausea or vomiting occurs, the likelihood of which is reduced when using Augmentin at the beginning of a meal.

Common side effects include candidiasis of the genitals, skin and mucous membranes.

The instructions state that allergic rashes do not occur very often, and more severe allergic reactions are extremely rare.

Rarely, there may be a decrease in leukocytes, platelets and neutrophils; dizziness or headache; moderate increase in liver transaminases. Very rarely - hemolytic anemia, convulsions, increased excitability, aseptic meningitis, hepatitis, impaired bile outflow, interstitial nephritis, excess salts in the urine.

Side effects are usually reversible, but for the expectant mother this is small consolation.

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Overdose

May be expressed in disorders of the digestive organs: nausea, vomiting, diarrhea; hyper- or dehydration; the appearance of excess salts in the urine. Therapy is based on symptoms, water-electrolyte metabolism is corrected.

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Interactions with other drugs

Not used in combination with probenecid and allopurinol. May affect the effectiveness of combined oral contraceptives, but this is unlikely to be relevant for pregnant women.

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Storage conditions

Store for no more than two years, maintaining a temperature of up to 25°C in a room with low humidity.

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Reviews

Reviews from women who had to undergo Augmentin therapy during pregnancy generally say that everything ended well. Some complain of allergic reactions, but their children are fine.