Comparative Pharmacology
Head-to-head clinical analysis: AUGMENTIN 400 versus BACTOCILL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AUGMENTIN 400 versus BACTOCILL.
AUGMENTIN '400' vs BACTOCILL
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.
BACTOCILL (nafcillin) is a penicillinase-resistant penicillin that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), thereby inhibiting transpeptidation and autolysin inhibitors. Active against Staphylococcus aureus and other gram-positive bacteria.
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.
250-500 mg orally every 6 hours or 1-2 g intravenously every 4-6 hours
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.
0.5-0.8 hours; prolonged to 2-4 hours in severe renal impairment
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.
Renal: 60-70% unchanged; biliary: 20-30% as active metabolite; fecal: 5-10%
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic