Comparative Pharmacology
Head-to-head clinical analysis: AUGMENTIN 400 versus UNASYN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AUGMENTIN 400 versus UNASYN.
AUGMENTIN '400' vs UNASYN
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.
Ampicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs); sulbactam is a beta-lactamase inhibitor that prevents degradation of ampicillin by beta-lactamases.
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.
3 g (ampicillin 2 g + sulbactam 1 g) IV every 6 hours; total daily dose of sulbactam not to exceed 4 g.
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.
Ampicillin: ~1 hour (normal renal function); sulbactam: ~1-1.4 hours (normal renal function); prolonged in renal impairment (ampicillin up to 20 hours, sulbactam up to 10-15 hours in anuria).
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: ampicillin (~75-90% unchanged) and sulbactam (~75-85% unchanged); biliary/fecal: minimal (<5% for each component).
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic