Panclav

Panclav is a broad-spectrum penicillin antibiotic. It is a β-lactamase inhibitor.

Indications Panklava

It is indicated for the elimination of inflammatory and infectious pathologies that are provoked by the pathogenic influence of microbes sensitive to the drug:

• the presence of infectious processes in the ENT organs (otitis or sinusitis in acute or chronic form, and in addition pharyngitis with tonsillitis);
• various infections associated with the respiratory system (bronchitis in acute or chronic form, pneumonia and pyothorax);
• infectious processes affecting the urinary system (including urethritis with cystitis and pyelonephritis);
• gynecological infections (including salpingo-oophoritis with salpingitis, as well as endometritis and pelvic peritonitis with septic abortion);
• infectious diseases associated with the joint and bone system (this includes chronic osteomyelitis);
• skin infections and soft tissue pathologies (including infectious processes due to wounds and phlegmon);
• infections in the bile ducts (including cholangitis with cholecystitis);
• chancroid and gonorrhea;
• odontogenic infections.

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Release form

Available in tablets of 250+125 mg and 500+125 mg. Each glass jar contains 15 or 20 tablets. One package contains 1 jar.

Panclav 500 mg/125 mg

1 tablet of Panclav 500 mg/125 mg contains 500 mg of amoxicillin (as trihydrate) and 125 mg of clavulinic acid (as potassium salt).

Panclav 875 mg/125 mg

1 tablet of Panclav 875 mg/125 mg contains 875 mg of amoxicillin (as trihydrate), as well as 125 mg of clavulinic acid (potassium salt).

Pharmacodynamics

Panclav is a combination drug that combines semi-artificial penicillin, which has a broad spectrum of antibacterial action, and clavulinic acid (an irreversible inhibitor of β-lactamases of types 2, 3, as well as 4 and 5; it is inactive against type 1).

Clavulinic acid forms a stable inactivated complex, which includes the enzymes mentioned, and also protects the substance amoxicillin from possible loss of antibacterial effectiveness, which is induced by the production of β-lactamases (this includes co-pathogens with the main bacteria-pathogens, and opportunistic microbes). Thanks to this combination, a pronounced bactericidal effect is ensured.

Panclav has a broad spectrum of antibacterial activity. It affects strains sensitive to amoxicillin, as well as strains that produce β-lactamases:

• among gram-positive aerobic microbes: pneumococci, Streptococcus pyogenes, Streptococcus viridans and Streptococcus bovis, as well as Staphylococcus aureus and Staphylococcus epidermidis (except for methicillin-resistant strains), Listeria spp. and enterococci;
• Among gram-negative aerobic microbes: whooping cough bacillus, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus influenzae, and Ducray bacillus. This also includes Klebsiella, Moraxella catarrhalis, gonococci, meningococci, Pasteurella multocida, Proteus, Salmonella, Shigella, Vibrio cholerae, and Yersinia enterocolitica;
• anaerobic bacteria: peptostreptococci and peptococci, clostridia, bacteroides and Actinomyces israelii.

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Pharmacokinetics

The main pharmacokinetic properties of clavulinic acid and amoxicillin are quite similar. Both of these substances are well absorbed when taken orally, and the degree of absorption is not affected by food intake. Peak plasma levels are observed approximately 1 hour after taking the drug.

These substances have a good distribution volume within tissues and fluids (in the middle ear with the lungs, peritoneal and pleural fluids, ovaries with the uterus, etc.). Amoxicillin is able to pass into the synovium, liver, prostate, muscle tissue, palatine tonsils, bronchial secretions and paranasal sinuses, as well as the gallbladder and saliva.

Amoxicillin with clavulinic acid do not pass through the BBB (if the membranes of the brain are not inflamed), but they are able to pass through the placenta and be excreted in breast milk.

The active components of the drug are weakly synthesized with plasma protein. Amoxicillin undergoes a partial process of metabolism, but the metabolism of clavulinic acid is most likely more intense.

The half-life of the active substances is 1-1.5 hours. This indicator increases in people suffering from severe renal failure - for amoxicillin it is 7.5 hours, and for clavulinic acid - 4.5 hours.

Amoxicillin is excreted in the kidneys – by glomerular filtration and tubular excretion. The substance is excreted almost unchanged. Clavulinic acid is excreted through glomerular filtration, and the substance is partially excreted as decay products. Small parts of the substance can be excreted through the lungs or intestines.

Both substances can be removed by hemodialysis. Peritoneal dialysis can only excrete a small amount of the drug.

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Dosing and administration

Oral administration is permitted for children aged 12 years and over (or weighing 40+ kg) and adults. To eliminate a moderate or mild infectious process, you need to drink 1 tablet (250 mg) three times a day. In case of a severe form of infection, a single dosage is increased to 2 tablets (250 mg) or 1 tablet (500 mg) and the medicine is taken three times a day.

The maximum adult daily dose of clavulinic acid (potassium salt) is 600 mg. Children's dose is 10 mg/kg. An adult is allowed to take no more than 6 g of amoxicillin per day, and a child - a maximum of 45 mg/kg.

The therapeutic course lasts about 5-14 days. Without a follow-up examination by a doctor, it is prohibited to continue treatment after 14 days.

To eliminate odontogenic infectious processes, it is recommended to take 1 tablet (500 mg) every 12 hours for 5 days.

People with renal insufficiency (CC level within 10-30 ml/minute) need to take the medicine in the amount of 1 tablet (500 mg) at intervals of 12 hours, and people with CC level less than 10 ml/minute – the same dose, but at intervals of 24 hours.

When treating anuria, the interval between drug intakes should be extended to 48 (or more) hours.

The medicine is taken orally with food. The tablet should not be chewed and should be washed down with water.

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Use Panklava during pregnancy

Panclav may be prescribed to pregnant or lactating women only in cases where the probable benefit from its use for the woman is greater than the possibility of negative consequences for the fetus.

Contraindications

Among the contraindications:

• infectious form of mononucleosis (also in case of occurrence of measles-like rashes);
• intolerance to cephalosporins with penicillins, as well as other β-lactam antibiotics and other components of the drug.

Side effects Panklava

As a result of taking the medicine, the following side effects may develop:

• Digestive system organs: development of vomiting, diarrhea, nausea, liver dysfunction, and increased liver transaminase activity. Hepatitis, intrahepatic cholestasis, and post-hepatic leukemia are occasionally observed;
• manifestations of allergy: the development of erythematous rash and urticaria. Rarely, anaphylaxis, erythema multiforme, angioedema and Stevens-Johnson syndrome develop. Ritter dermatitis occurs sporadically;
• others: the appearance of superinfection and the development of candidiasis, as well as a treatable increase in PTT values.

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Overdose

Symptoms of overdose: gastrointestinal disturbances, as well as water and electrolyte imbalance.

Symptomatic treatment is required to eliminate the disorders. Hemodialysis will also be effective.

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Interactions with other drugs

In combination with glucosamine, antacid drugs, aminoglycosides and laxatives, the absorption of Panclav is slowed down, and in combination with vitamin C, on the contrary, it is accelerated.

Combination with bactericidal antibiotics (including cephalosporins with aminoglycosides, vancomycin with cycloserine and rifampicin) causes a synergistic effect. With bacteriostatic drugs (such as sulfonamides with macrolides and tetracyclines, as well as chloramphenicol and lincosamides) - leads to an antagonistic effect.

Combination with indirect anticoagulants leads to an increase in their effect (in this case, intestinal microflora is suppressed, as well as the level of PTI and vitamin K binding is reduced). As a result, with such a combination, it is necessary to regularly monitor blood clotting indicators.

Combination with oral contraception, ethinyl estradiol and drugs whose metabolism leads to the formation of PABA reduces the effectiveness of these drugs, resulting in the risk of acyclic bleeding.

Allopurinol, diuretic drugs, NSAIDs with phenylbutazone and other drugs that block tubular secretion increase amoxicillin levels (while clavulinic acid is excreted to a greater extent by glomerular filtration).

Combining the drug with allopurinol also increases the likelihood of skin rashes.

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Storage conditions

Panclav should be kept in a place protected from sunlight and moisture, and out of reach of small children. The temperature level should be within 15-25°C.

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Shelf life

Panclav can be used for a period of 2 years from the date of manufacture of the medicine.

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