Comparative Pharmacology
Head-to-head clinical analysis: AUGMENTIN 400 versus AUGMENTIN ES 600.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AUGMENTIN 400 versus AUGMENTIN ES 600.
AUGMENTIN '400' vs AUGMENTIN ES-600
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Augmentin '400' is a combination of amoxicillin (a beta-lactam antibiotic) and clavulanate (a beta-lactamase inhibitor). Amoxicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), while clavulanate irreversibly inhibits beta-lactamase enzymes, preventing inactivation of amoxicillin.
AUGMENTIN ES-600 is a combination of amoxicillin, a beta-lactam antibiotic, and clavulanate, a beta-lactamase inhibitor. Amoxicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), while clavulanate irreversibly inhibits beta-lactamase enzymes, preventing degradation of amoxicillin.
500 mg (amoxicillin 400 mg / clavulanate 57 mg) orally every 12 hours or 875 mg (amoxicillin 700 mg / clavulanate 100 mg) orally every 12 hours; usual duration 5-10 days.
90 mg/kg/day orally divided every 12 hours (based on amoxicillin component). Maximum 4000 mg amoxicillin/600 mg clavulanate per day.
None Documented
None Documented
Amoxicillin: 1-1.3 hours (prolonged to ~7 hours in renal impairment, e.g., CrCl <10 mL/min). Clavulanate: 1-1.2 hours (prolonged in renal impairment). Clinical context: Dosing interval adjustment required for CrCl <30 mL/min.
Amoxicillin: ~1.0-1.5 hours in adults with normal renal function; clavulanate: ~1.0-1.2 hours. In renal impairment, half-life prolongs significantly (amoxicillin up to 7-20 hours in ESRD).
Amoxicillin: ~50-70% renal (tubular secretion and glomerular filtration) as unchanged drug, remainder metabolized to penicilloic acid. Clavulanate: ~30-50% renal as unchanged drug, remainder metabolized and excreted via bile/feces. Total renal clearance accounts for ~60-80% of elimination for both components.
Amoxicillin: ~50-70% excreted unchanged renally via glomerular filtration and tubular secretion; clavulanate: ~25-40% excreted unchanged renally. Combined: renal excretion accounts for ~60-80% of elimination, with minor biliary/fecal elimination (approx 5-15% for amoxicillin).
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic