Comparative Pharmacology
Head-to-head clinical analysis: AUGMENTIN 200 versus BICILLIN L A.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AUGMENTIN 200 versus BICILLIN L A.
AUGMENTIN '200' vs BICILLIN L-A
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Amoxicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), while clavulanate irreversibly inhibits beta-lactamases, preventing degradation of amoxicillin.
Penicillin G benzathine is a slow-release formulation that provides prolonged tissue concentrations. It inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidation, and activating autolytic enzymes, leading to cell lysis.
One 200 mg amoxicillin/28.5 mg clavulanate chewable tablet every 8 hours for mild to moderate infections; for severe infections, one 400 mg/57 mg tablet every 12 hours or one 200 mg/28.5 mg tablet every 8 hours.
1.2 million units intramuscularly as a single dose for treatment of streptococcal pharyngitis; for syphilis, 2.4 million units intramuscularly weekly for 1-3 weeks depending on stage.
None Documented
None Documented
Amoxicillin: ~1 hour in healthy adults, prolonged to 7-20 hours in renal impairment (CrCl <10 mL/min). Clavulanate: ~1 hour, similarly prolonged in renal impairment. The combination's half-life supports twice-daily dosing for most infections.
Terminal half-life: 30-60 hours (prolonged due to slow absorption from IM depot; clinically allows single-dose regimen for syphilis)
Amoxicillin: ~50-70% excreted unchanged in urine via glomerular filtration and tubular secretion, with the remainder hepatically metabolized and excreted in bile and feces. Clavulanate: ~30-50% excreted unchanged in urine, the rest metabolized and eliminated in bile and feces.
Renal: 60-90% unchanged; biliary/fecal: minor (<10%)
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic