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Safety Information

Augmentin Contraindications & InteractionsWhen Not to Use & Important Drug Interactions

Understanding when Augmentin should not be used is crucial for your child's safety. Most importantly, avoid this medication if your child has had allergic reactions to penicillin-type antibiotics or previous liver problems with this specific medication.

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Augmentin contraindications include absolute restrictions (true penicillin allergies, previous liver toxicity) and relative cautions (mono, kidney disease, PKU). Drug interactions are significant with warfarin, probenecid, and oral contraceptives. Understanding these helps ensure safe, effective treatment.

Contraindications

Absolute Contraindications (Never Use)

Unspecified condition

Any history of immediate hypersensitivity to amoxicillin, clavulanate, or other beta-lactam antibiotics

Unspecified condition

History of cholestatic jaundice, hepatitis, or liver dysfunction specifically related to amoxicillin-clavulanate use

Relative Contraindications (Use With Caution)

Clostridioides difficile-Associated Diarrhea

As with all antibiotics, Augmentin may disrupt normal gut flora, increasing the risk for C. difficile colitis. Use caution in children with a history of C. diff infection. Severe or prolonged diarrhea should prompt immediate evaluation to rule out this complication.

Mononucleosis (EBV Infection)

Augmentin, like amoxicillin, should be avoided in children with suspected Epstein-Barr virus infection, as it may provoke a diffuse, non-allergic rash. Although not dangerous, the rash may be confused with a drug allergy and is better avoided by using a different treatment.

Severe Renal Impairment

In children with significantly impaired kidney function, Augmentin may require dose adjustments or extended intervals between doses. The clavulanate component is cleared renally and can accumulate if not properly adjusted. Dosing should be guided by a pediatric specialist in such cases.

PKU Consideration

Some chewable tablets and suspensions may contain phenylalanine as part of the sweetener system, which is relevant for children with phenylketonuria (PKU). Always check the product labeling if this is a concern, especially with flavored chewables.

Pregnancy & Lactation

This medication is generally considered safe during pregnancy and breastfeeding when used as directed. However, if you're pregnant or breastfeeding and need to give this medication to your child, it's always a good idea to discuss this with your healthcare provider to ensure it's the best choice for your specific situation.

Drug Interactions

major interaction

Specific drugs: See description

Effect: Increased bleeding risk, elevated INR

How it happens: Enhanced anticoagulant effect through altered gut flora and vitamin K synthesis

Management: Monitor INR more frequently; consider warfarin dose adjustment

moderate interaction

Specific drugs: See description

Effect: Increased amoxicillin levels and prolonged half-life

How it happens: Decreased renal tubular secretion of amoxicillin

Management: May require amoxicillin dose reduction

moderate interaction

Specific drugs: See description

Effect: Reduced contraceptive efficacy

How it happens: Disruption of enterohepatic circulation by altering gut flora

Management: Recommend backup contraception during treatment

major interaction

Specific drugs: See description

Effect: Increased methotrexate toxicity risk

How it happens: Reduced renal clearance of methotrexate

Management: Monitor methotrexate levels; consider dose adjustment

moderate interaction

Specific drugs: See description

Effect: Higher incidence of rash

How it happens: Increased risk of skin reactions

Management: Monitor closely for skin reactions

Disease State Considerations

Inflammatory bowel disease (IBD)

Unknown

No information available

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Unknown

No information available

Safety Screening Tools

Monitoring Requirements

Hypersensitivity reactions

Frequency

Continuous during first dose, then daily

Liver function

Frequency

Monitor symptoms daily, labs if prolonged treatment

Gastrointestinal effects

Frequency

Daily monitoring

Clinical References

Augmentin Prescribing Information and Contraindicationsโ€ขFDA Drug Database (2023)regulatory standardPediatric data
Beta-Lactam Allergy Assessment in Childrenโ€ขJournal of Allergy and Clinical Immunology (2023)clinical guidelinePediatric data
Drug-Induced Liver Injury from Amoxicillin-Clavulanateโ€ขHepatology (2022)case seriesPediatric data
Antibiotic Drug Interactions in Pediatric Practiceโ€ขPediatric Clinics of North America (2023)expert reviewPediatric data