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Panklav (Augmentin)

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Panklav is a penicillin antibiotic with a notably broad spectrum of activity. The bi-layer tablets provide an immediate release of amoxicillin and clavulanate potassium and an extended release of amoxicillin. This enhanced formulation prolongs the time that bacteria are exposed to the antibiotic and promotes coverage of tough-to-treat S. pneumoniae.

Other names for this medication:
Alfoxil, Alphamox, Amixen, Amobay, Amocla, Amoclan, Amodex, Amoklavin, Amoksiklav, Amorion, Amoval, Amoxan, Amoxibeta, Amoxicap, Amoxiclav, Amoxidal, Amoxidin, Amoxihexal, Amoxiplus, Amoxival, Amoxsan, Amoxy, Amoxycare, Ampliron, Amylin, Augmentin, Augmex, Augpen, Bactoclav, Betamox, Bioclavid, Biomox, Blumox, Cavumox, Cilamox, Clabat, Clamentin, Clamicil, Clamoxin, Claneksi, Clavam, Clavamel, Clavamox, Clavaseptin, Clavet, Clavipen, Clavobay, Clavubactin, Clavulin, Clavulox, Clonamox, Curam, Dexyclav, Duomox, Enhancin, Exten, Fleming, Fulgram, Germentin, Gimaclav, Gloclav, Glomox, Hiconcil, Himox, Hymox, Imadrax, Julmentin, Julphamox, Kesium, Klamoks, Klavox, Klavunat, Largopen, Macropen, Medoclav, Megamox, Megapen, Moxatag, Moxiclav, Moxilen, Moxypen, Myclav, Mymox, Natravox, Neomox, Nisamox, Noprilam, Noroclav, Novaclav, Novamox, Novax, Novocilin, Optamox, Origin, Pediamox, Pinamox, Ranclav, Ranmoxy, Ranoxyl, Rapiclav, Ronemox, Sulbacin, Synulox, Trifamox, Unimox, Xiclav, Zoxil

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Also known as:  Augmentin.


Panklav is a brand name for an antibiotic, called co-amoxiclav, that is used to treat a wide range of conditions, from bronchitis to Lyme disease. It is one of the most commonly prescribed antibiotics for children, frequently dispensed for ear infections.

The drug is a combination of two active ingredients: amoxicillin and clavulanic acid. Together, the drugs fight bacteria that would ordinarily be resistant to amoxicillin alone.


Panklav is typically taken orally, in pill form for adults, and in a liquid (often flavored) suspension for little children. Doctors prescribe the drug so often because it works against many types of disease-causing bacteria.

"When I travel I always have some Panklav in my travel bag," because it works against so many common infections, said Dr. Alasdair Geddes, an emeritus professor of infectious diseases at the University of Birmingham in England, who ran some of the first clinical trials of Panklav.

Panklav is one of the workhorses of the pediatrician's office, prescribed for ear infections that are resistant to amoxicillin alone, sore throats and certain eye infections. The drug is also a powerful agent against bronchitis and tonsillitis caused by bacteria (though many cases of sore throat are viral in origin).

In addition, the drug can fight pneumonia, urinary tract infections, gonorrhea, and skin infections. The drug has also been seen as a good potential candidate for treatment of Lyme disease, chlamydia, sinusitis, gastritis and peptic ulcers, according to a 2011 study in the International Journal of Pharmacy and Pharmaceutical Sciences.

Though Panklav hasn't been conclusively shown to be safe during pregnancy, some studies suggest it is unlikely to do harm to pregnant women or their fetuses, according to a 2004 study in the British Journal of Clinical Pharmacology. Women who are pregnant should check with their doctors before taking the drug. The Food and Drug Administration classifies Panklav as a class B drug, meaning there is no evidence for harm.


If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.


Store between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Keep bottle closed tightly. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Panklav are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


A high percentage of patients with mononucleosis who receive amoxicillin develop an erythematous skin rash. Thus, Panklav should not be administered to patients with mononucleosis.

The possibility of superinfections with fungal or bacterial pathogens should be considered during therapy. If superinfection occurs, amoxicillin/clavulanate potassium should be discontinued and appropriate therapy instituted.

Panklav Chewable tablets and Panklav Powder for Oral Solution contain aspartame which contains phenylalanine. Each 200 mg chewable tablet of Panklav contains 2.1 mg phenylalanine; each 400 mg chewable tablet contains 4.2 mg phenylalanine; each 5 mL of either the 200 mg/5 mL or 400 mg/5 mL oral suspension contains 7 mg phenylalanine. The other formulations of Panklav do not contain phenylalanine.

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The in vitro activity of R-3746, an iminomethoxy aminothiazolyl cephalosporin with a CH2OCH3 moiety at position 3, was compared with those of other antibiotics. R-3746 inhibited the majority of hemolytic streptococci (groups A, B, C, F, and G) and Streptococcus pneumoniae at less than 0.06 micrograms/ml, which was comparable to the activity of amoxicillin, 2- to 8-fold more active than cefixime, and 16- to 64-fold more active than cefaclor and cephalexin. Ninety percent of beta-lactamase-producing Haemophilus influenzae and Neisseria gonorrhoeae were inhibited at a concentration 0.25 micrograms/ml, but it was less active against Branhamella spp. It did not inhibit (MIC, greater than 16 micrograms/ml) enterococci, viridans group streptococci, or methicillin-resistant staphylococci. The MICs of R-3746 for 90% of strains tested for Escherichia coli; Klebsiella pneumoniae; Citrobacter diversus; Proteus mirabilis; and Salmonella, Shigella, and Yersinia spp. were less than or equal to 1 micrograms/ml. It was two- to eightfold less active than cefixime but was markedly superior to cefaclor, cephalexin, amoxicillin-clavulanate, and trimethoprimsulfamethoxazole. R-3746 inhibited 50% of Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii, Morganella spp., Providencia spp., Proteus vulgaris, and Serratia marcescens at less than or equal to 8 micrograms/ml. Pseudomonas spp. were resistant. Fifty percent of Clostridium spp. were inhibited by 0.5 micrograms/ml, but MICs for Bacteroides spp. were greater than 128 micrograms/ml. R-3746 was not appreciably hydrolyzed by most chromosomal and plasmid-mediated beta-lactamases.

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The susceptibility of anaerobic bacteria remains stable in Belgium, except for clindamycin, which shows a continuous decrease in activity. However, for each of the tested antibiotics, at least a few resistant organisms were detected. Consequently, for severe infections involving anaerobic bacteria, it could be advisable to perform microbiological testing instead of relying on known susceptibility profiles. Periodically monitoring background susceptibility remains necessary to guide empirical therapy.

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This study evaluated the need for antibiotic prophylaxis in orthognathic surgery.

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Antibiotics to treat endodontic infections are routinely prescribed based on previously published susceptibility tests. There is increased concern that bacteria have increased resistance to the currently recommended antibiotics. The purpose of this investigation was to perform antibiotic susceptibility tests on a panel of bacteria recently isolated from endodontic infections. The bacteria in this study were aseptically aspirated with a needle from endodontic abscesses, cultivated, and identified at the species level. Each of the 98 species of bacteria was tested for antibiotic susceptibility to a panel of six antibiotics using the Etest. The antibiotics were penicillin V, amoxicillin, amoxicillin + clavulanic acid, clindamycin, metronidazole, and clarithromycin. The percentages of susceptibility for the 98 species were penicillin V: 83/98 (85%), amoxicillin: 89/98 (91%), amoxicillin + clavulanic acid: 98/98 (100%), clindamycin: 94/98 (96%), and metronidazole: 44/98 (45%). Metronidazole had the greatest amount of bacterial resistance; however, if it is used in combination with penicillin V or amoxicillin, susceptibility of the combination with penicillin V or amoxicillin increased to 93% and 99%, respectively. Clarithromycin seems to have efficacy, but it is still considered an antibiotic under investigation because the minimum inhibitory concentration has not been established.

panklav antibiotic

The four phenotypically different E. coli isolates were classified into four clones and two phylogenetic groups (B2 and A), and displayed different virulence gene patterns. The two isolates resistant to co-amoxiclav were phylogenetically and clonally different, and harboured two different bla(TEM) genes.

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The results and predictions were consistent with the knowledge in this field. The model may be useful to optimize clinical trial designs and drug dosing regimens.

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Two controlled clinical trials compared loracarbef (LY163892 with amoxicillin/clavulanate or amoxicillin in the treatment of acute exacerbations of chronic bronchitis. Collectively, of 1,057 patients enrolled, 390 qualified for analysis: group 1 comprised 200 patients treated with loracarbef (400 mg twice daily); group 2, 120 patients treated with amoxicillin/clavulanate (500 mg three times daily); and group 3, 70 patients treated with amoxicillin (500 mg three times daily). Symptomatic and bacteriologic outcomes were assessed at post-therapy (within 72 hours of therapy completion), and at late-posttherapy (10-14 days after therapy completion). These evaluations were combined to provide an "overall" evaluation that accounted for all unfavorable outcomes occurring at either the posttherapy or late-posttherapy visit. At the posttherapy evaluation, 93.0% of group 1 patients, 95.0% of group 2 patients, and 88.6% of group 3 patients demonstrated favorable clinical outcomes (cure or improvement). "Overall" favorable clinical outcomes were achieved in 88.0% of group 1 patients, 90.0% of group 2 patients, and 81.4% of group 3 patients. Bacteriologic results from the two studies could not be merged due to marked differences in how posttherapy bacteriologic results were assessed. The clinical significance of positive posttherapy sputum cultures was doubtful: 90% of patients with a positive sputum culture at the posttherapy visit who returned for the late-posttherapy visit had successful clinical outcomes documented at the late-posttherapy evaluation. Loracarbef was associated with a lower incidence of diarrhea and a higher incidence of headache as compared with amoxicillin/clavulanate. These results suggest that 400 mg loracarbef twice daily for 7 days is effective and safe in the treatment of acute exacerbations of chronic bronchitis.

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In a taste test of 4 antimicrobial agents, azithromycin (cherry flavored), cefprozil (bubble gum flavored), cefixime (strawberry flavored), and amoxicillin-clavulanic acid (banana flavored) were compared.

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panklav 1000 mg 2017-01-26

A contemporary (2002-2003) national collection of 2100 strains of Streptococcus pneumoniae obtained from 30 sites in the nine United States (US) census regions were tested to determine the comparative antimicrobial properties of amoxicillin/clavulanate and 15 other antimicrobials. The rank order of antimicrobials with the lowest susceptibility rates was: penicillin (67.9%)or=41.1%), trimethoprim/sulphamethoxazole (38.9%), tetracyclines (22.2%) and clindamycin (10.0%). Geographical variation in the susceptibility patterns among US census zones was present with lowest penicillin and erythromycin susceptibility noted for West South Central and West North Central zones Tavanic 800 Mg (or=+0.9%), sinus isolates (+2.7%), middle ear fluid isolates (+5.5%), penicillin-resistant strains (>or=+5.8%) and strains from patients <2 years of age (>or=+2.4%). Local and global surveillance studies of common respiratory pathogens such as S. pneumoniae remain instrumental to guide clinicians in appropriate empirical treatments and to emphasize the need for prudent antimicrobial use.

panklav tablete 625 mg 2017-06-08

The aim of this prospective, randomized study was to compare amoxicillin-clavulanic acid with cefazolin as ultra-short term prophylaxis in vaginal gynecologic surgery. It was conducted at the Department of Obstetrics and Gynecology, University of Bari. Patients were randomly allocated to receive amoxicillin-clavulanic acid (2.2 g) [Group A] or cefazolin (2 g) [Group B] as a single dose 30 minutes before surgery. Each patient was assessed daily until discharge to Ziana Generic Name evidence febrile status and the presence of infections at the operative site, urinary tract and respiratory tract. In the amoxicillin-clavulanic acid (Group A) and cefazolin (Group B) groups, overall 88 and 90 patients, respectively, were evaluable for prophylactic efficacy at hospital discharge. Infectious complications were infrequent in both arms, with febrile morbidity occurring in 4 (4.5%) and 16 (8.9%) patients respectively in the amoxicillin-clavulanic acid and cefazolin groups (p=0.016). Urinary tract infections were higher but not significantly in the amoxicillin-clavulanic acid group (6.8% versus 4.4 %), whereas asymptomatic bacteriuria was detected in 2.2% of the patients in both groups. There was no respiratory tract infection or septic death in either group. It is concluded that ultra-short term prophylaxis with both amoxicillin-clavulanic acid and cefazolin is safe and effective in elective vaginal gynecologic surgery.

panklav 625 mg 2015-01-23

The study indicated that AST methods correlated with one another when testing S. enterica Moxifloxacin Drops Dosage serovar Heidelberg isolates, with a few exceptions. In general, discrepancies among the methods were due to isolates being interpreted as intermediately susceptible or due to an increased number of resistances detected with Sensititre and a lower number with Vitek.

panklav 500 mg cena 2016-08-05

Liver damage associated with the amoxicillin-clavulanate combination is more frequent in patients over the age of 50 and during long-term treatment Rozex Gel Topico . It is mainly due to the clavulanic acid component of the drug. It is better to reserve this combination for infections due to bacteria that are resistant to amoxicillin.

panklav drug 2015-07-07

To compare the effectiveness of CA Cefpodoxime Human Dose (10mg/kg) and CTX (200mg/kg) against centrally-mediated endpoints, we investigated their effects against morphine's rewarding, hyperthermic, and locomotor-sensitizing actions. Endpoints were based on prior evidence that CTX attenuates morphine-induced physical dependence, tolerance, and hyperthermia.

panklav 125 mg 2017-08-08

Following the recommendations of a previous audit, specific objectives were chosen for reaudit. The aim was to measure the adherence to agreed protocols for the use of prophylactic antimicrobial agents; including the use of the once only part of the Kardex and to measure the adherence to protocols for the use of parenteral co-amoxiclav and metronidazole. The audit was conducted in the same hospital as the original study. Data was collected for one month on all patients receiving prophylactic antimicrobial agents, parenteral co-amoxiclav or metronidazole. A microbiologist assessed the compliance to the agreed written protocols, which had Rozex Buy been distributed and explained to each resident. One hundred and eighty-eight patients received 226 antimicrobial courses (649 doses). Seventy-two per cent of courses were considered appropriate compared with 65% in 1993. The criteria for this audit only allowed one cephalosporin choice per directorate and accounted for the inappropriateness of choice to be 19% compared with 12% in 1993. This was confined to one directorate and an overall improvement of 79% would have been achieved if any cephalosporin could be chosen as 1993. Eighty-two per cent of doses were considered appropriate if written in the once only part of the Kardex or the anaesthetic sheet compared with 51% of those written in the general part. Only nine per cent of courses were too long compared with 16% in 1993. Fifty seven patients were given 125 days of co-amoxiclav, 94 days for treatment and 31 days for prophylaxis. Co-amoxiclav use overall was 33% less than 1993 with an improvement of appropriateness from 30% to 68%.

panklav 625 mg cena 2017-07-29

Our results indicate that delayed initiation of antimicrobial treatment does not worsen the recovery from acute otitis media, as measured by improvement during treatment. However, watchful waiting before the initiation of delayed antimicrobial treatment might be associated with transient worsening of a child's condition, prolongation of symptoms and economic Cephalexin Syrup losses.

panklav 2x 1000 mg 2016-12-31

Nosocomial outbreaks of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae are an increasing concern in neonatal intensive care units (NICUs). We describe an outbreak of ESBL-producing K. pneumoniae that lasted 5 months and affected 23 neonates in our NICU. Proton pump inhibitor and extended-spectrum cephalosporin exposure were significantly associated with the risk of ESBL-producing K. pneumoniae colonisation and/or infection. Thirty isolates recovered from clinical, screening and environmental samples in the NICU were studied by means Omnicef Max Dose of Raman spectroscopy, pulsed-field gel electrophoresis and repetitive extragenic palindromic polymerase chain reaction (rep-PCR). The Raman clustering was in good agreement with the results of the other two molecular methods. Fourteen isolates belonged to the Raman clone 1 and 16 to the Raman clone 3. Molecular analysis showed that all the strains expressed SHV-1 chromosomal resistance, plasmid-encoded TEM-1 and CTX-M-15 β-lactamases. Incompatibility groups of plasmid content identified by PCR-based replicon typing indicated that resistance dissemination was due to the clonal spread of K. pneumoniae and horizontal CTX-M-15 gene transfer between the two clones.

panklav antibiotic 2016-11-09

Antibiotic administration during acute appendicitis in children continues to be debated. The purpose of this study was to compare efficacy of two prophylactic antibiotic treatment guidelines in acute appendicitis and peritonitis in children.

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Antibiotics decrease the mortality rate among the pneumonia patients provided that it is given early in the disease.

panklav 875 mg 2016-11-12

The resistance phenotype of the clinical isolate of Escherichia coli 1941 was characterized by high-level resistance to penicillins and to combinations amoxicillin-ticarcillin/clavulanate and ampicillin/sulbactam. This resistance was carried by the conjugative plasmid pEC1941 that encoded a beta-lactamase activity. The purified enzyme focused at pI 5.4 and was strongly inhibited in vitro by clavulanic acid (IC50 = 0.09 microM). Nucleotide sequence analysis revealed identity between the plasmid borne blaTEM gene of E. coli 1941 and the blaTEM-1B gene, except for a single C-to-T substitution at position 32 in the promoter region leading to the overlapping promoters Pa and Pb. No alterations in the expression of outer membrane porins OmpC and OmpF have been detected. These findings show that the resistance of E. coli 1941 to the combinations of beta-lactams with beta-lactamase inhibitors is related to high-level production of TEM-1 enzyme expressed from the strong promoters Pa and Pb.

panklav 250 mg 2017-08-31

Saccharomyces boulardii is a non-pathogenic yeast with biotherapeutic properties that has been used successfully to prevent and to treat various infectious and antibiotic-associated diarrheas. The intestinal microbiota is responsible for colonization resistance and immune response to pathogens but can be disrupted by antibiotics and lose its barrier effect. Dendritic cells (DCs) are professional antigen-presenting cells of the immune system with the ability to initiate a primary immune response or immune tolerance. In a human microbiota-associated mouse model, we evaluated the influence of S. boulardii on the composition of the microbiota and on the properties of dendritic cells in normal homeostatic conditions and after antibiotic-induced stress. The DCs were derived from splenic precursors. Membrane antigen expression and phagocytosis of FITC-latex beads by DCs were evaluated by flow cytometry. The molecular analysis of the microbiota was performed with fluorescence in situ hybridization (FISH) combined with flow cytometry or confocal microscopy using group specific 16S rRNA targeted probes. This evaluation was conducted during and after a 7-day oral treatment with amoxicillin-clavulanic acid alone and in combination with the administration of the yeast. The antibiotic treatment increased the phagocytic activity of DCs. Their antigen presenting function (MHC class II antigen and CD 86 costimulatory molecule membrane expression) was up-regulated. This reflects a functional activation of DCs. In the presence of S. boulardii, the modification of membrane antigen expression was down regulated. To correlate these modifications to the microbiota disruption, we analyzed in parallel the composition of the intestinal microbiota. As previously shown, the amoxicillin-clavulanic acid treatment, both alone and with S. boulardii, did not quantitatively alter the total microbiota. In contrast, after one day of the antibiotic treatment the Clostridium coccoides group decreased dramatically in the two groups of mice treated with the antibiotic. The level then increased regularly, and at days 17, 22 and 24 it increased faster (P < 0.05) in the AB+ Sb group than in the AB group, reaching the initial level at day 29. The Bacteroides group in the two groups of mice increased during the antibiotic treatment and decreased after the antibiotic was stopped, reaching the initial level. The rate of decrease was faster for the AB+ Sb group than for the AB group, with a significant difference (P < 0.05) at days 17 and 22. During antibiotic treatment, the Enterobacteriaceae group became detectable and its level increased in both groups of mice. After discontinuation of the antibiotic, its level decreased to become undetectable at day 29, without significant difference between the two groups. These results showed that S. boulardii treatment tends to restore the balance of the dominant anaerobic microbiota more rapidly in human microbiota associated-mice treated with amoxicillin-clavulanic acid; the results also suggest that the yeast has a role in modulating the specific immune response to microbial associated-molecular patterns. This may explain, at least in part, the beneficial effects of S. boulardii in preventing antibiotic-associated diarrhea. This also suggests that the yeast plays a role in maintaining intestinal homeostasis.