Comparative Pharmacology
Head-to-head clinical analysis: AUGMENTIN 400 versus BICILLIN C R 900 300.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AUGMENTIN 400 versus BICILLIN C R 900 300.
AUGMENTIN '400' vs BICILLIN C-R 900/300
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.
Penicillin G benzathine and penicillin G procaine are beta-lactam antibiotics that inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), disrupting peptidoglycan cross-linking, leading to cell lysis via autolytic enzymes. Synergistic action covers both susceptible Gram-positive cocci (e.g., Streptococcus pyogenes) and some Gram-negative cocci (e.g., Neisseria spp.).
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.
Intramuscular injection: 1.2 mL (900,000 units penicillin G benzathine and 300,000 units penicillin G procaine) every 48 hours for 3 doses; for severe infections, up to 2.4 mL (1,800,000/600,000 units) as a single dose.
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.
0.5-1 hour for penicillin G; prolonged to 3-6 hours in renal impairment. Procaine component has no significant effect on elimination half-life
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: 60-90% as unchanged drug; biliary/fecal: minor (less than 10%)
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic