Famiclav is indicated for Pharyngitis, Acute otitis media, Lyme disease, Susceptible infections, Sinusitis,Otitis media, Skin and skin structure infections,Tonsillitis, Respiratory tract infections, Acute Maxillary Sinusitis, Urinary tract infections, Acute bacterial exacerbation of chronic bronchitis, Surgical Prophylaxis

Precautions and warnings

Severe renal impairment; pregnancy, lactation; hypersensitivity to penicillins.

Side-effects

Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhoea, GI disturbances; erythema multiforme, Stevens-Johnson syndrome, epidermal necrolysis.
Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.

Drug Interactions

May enhance the nephrotoxic effect of strong-acting diuretics (e.g. furosemide) and aminoglycosides. May enhance the effect of oral anticoagulants. May reduce the efficacy of OCs. Probenecid prolongs the excretion of cefuroxime and elevated peak serum level.

Contraindications

Hypersensitivity to cephalosporins.

Mode of actions

Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Addition of clavulanate inhibits beta-lactamase-producing bacteria; Clavulanic acid has a high affinity for and binds to certain ?-lactamases that generally inactivate Cefuroxime by hydrolyzing its ?-lactam ring. Combining clavulanate potassium with Cefuroxime extends the antibacterial spectrum of Cefuroxime to include many bacteria normally resistant to Cefuroxime and other penicillins and cephalosporins.

Dosage & Administration

Adolescents & adults:
Pharyngitis or Tonsillitis: 250 mg twice daily 5-10 days
Acute bacterial maxillary sinusitis: 250 mg twice daily 10 days
Acute bacterial exacerbation of chronic bronchitis: 250-500 mg twice daily 10 days
Secondary bacterial infections of acute bronchitis: 250-500 mg twice daily 5-10 days
Community acquired pneumonia: 250-500 mg twice daily 5-10 days
Uncomplicated skin & skin-structure infections: 250-500 mg twice daily 10 days
MDR Typhoid fever: 500 mg twice daily 10-14 days
Uncomplicated urinary tract infection: 250 mg twice daily 7-10 days
Uncomplicated gonorrhea: 1000 mg single dose
Lyme disease: 500 mg twice daily 20 days

Paediatric patients (3 months to 12 years)
Pharyngitis or Tonsillitis: 20 mg/kg/day in two divided doses 5-10 days
Acute otitis media: 30 mg/kg/day in two divided doses 10 days
Acute bacterial maxillary sinusitis: 30 mg/kg/day in two divided doses 10 days
Community acquired pneumonia: 30 mg/kg/day in two divided doses 5-10 days
MDR Typhoid fever: 30 mg/kg/day in two divided doses 10-14 days
Uncomplicated skin & skin-structure infections: 30 mg/kg/day in two divided doses 10 days
Uncomplicated urinary tract infection: 20 mg/kg/day in two divided doses 7-10 days

Pregnancy & Lactation

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.