Comparative Pharmacology
Head-to-head clinical analysis: AUGMENTIN ES 600 versus BICILLIN C R 900 300.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AUGMENTIN ES 600 versus BICILLIN C R 900 300.
AUGMENTIN ES-600 vs BICILLIN C-R 900/300
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
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.).
90 mg/kg/day orally divided every 12 hours (based on amoxicillin component). Maximum 4000 mg amoxicillin/600 mg clavulanate per day.
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: ~1.0-1.5 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).
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% 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).
Renal: 60-90% as unchanged drug; biliary/fecal: minor (less than 10%)
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic