Aren't amoxicillin and amoxicillin clavulanate different?

Xiao Zhang is a pharmacist in a hospital. He received a call from home while at work saying that his daughter Xiaomei had a slight fever and cough... After hearing this, Xiao Zhang asked his family to let the child drink more water and take some antipyretics.

When Xiao Zhang got home from get off work, he saw Xiao Mei's grandfather feeding medicine to the child. Xiao Zhang asked: "Dad, what medicine did you give Xiao Mei?" Xiao Mei's grandfather said: "Amoxicillin! Take the medicine and you will get better quickly!" Xiao Zhang said: "Amoxicillin is an antibacterial drug, you can't take it casually. Don't take it if there is no clear bacterial infection!" Then he picked up the medicine box and took a closer look: "Oh, Dad, this is still amoxicillin clavulanate potassium! Don't feed it!" Grandpa was a little unhappy and said: "This is amoxicillin! Isn't it written clearly - A-mo-xi-lin. This is just a different manufacturer, and the medicine box packaging is different!"

Just as Xiao Zhang was about to explain, his wife happened to come home from get off work. She walked in and saw that the atmosphere was not right. After understanding the whole story, she picked up the medicine box and looked at it carefully. She said to Xiao Mei's grandfather, "Dad, it says amoxicillin on the medicine box, but there are a few more words at the end. Look - potassium clavulanate. I don't know if these two are the same medicine, but the child is young, so we should be careful when using medicine!" She turned around and said to Xiao Zhang, "Or, let's not use the medicine ourselves. I think the child's condition is quite serious. Let's go to the hospital!"

The three of them picked up the child and rushed to the hospital. After examination, it was confirmed that Xiaomei had tonsillitis caused by bacterial infection, and the doctor prescribed amoxicillin granules.

When they got home, they quickly fed the child the medicine and coaxed him to sleep. Xiaomei's grandfather picked up the two medicine boxes and studied them carefully. As he looked at them, he said, "Didn't the doctor also prescribe amoxicillin? Why can't this be used?" This time, Xiao Zhang didn't get anxious. He patiently explained to his wife and father the differences between amoxicillin and amoxicillin-clavulanate potassium.

Similar drug names, different effects

Although both drugs are antibacterial drugs and have similar names, they are not the same. Simply put, amoxicillin clavulanate potassium is an upgraded product of amoxicillin, and clavulanate potassium is a kind of "protective cover" for amoxicillin, protecting amoxicillin from being "destroyed".

Amoxicillin is a penicillin antibiotic that exerts its bactericidal effect by inhibiting bacterial cell wall synthesis, which can rapidly dissolve and rupture bacteria into spherical bodies. It has good antibacterial activity against Streptococcus pneumoniae, hemolytic Streptococcus and other Streptococcus species, aerobic Gram-negative bacteria such as Escherichia coli and Proteus mirabilis that do not produce β-lactamase, and Helicobacter pylori.

Amoxicillin and clavulanate potassium is a compound drug composed of amoxicillin and clavulanate potassium. Clavulanate potassium is a β-lactamase inhibitor, which has a strong and broad-spectrum inhibitory effect on β-lactamase, and can inhibit the production of β-lactamase by bacteria. It has an inhibitory effect not only on the enzymes of Staphylococcus aureus, but also on the enzymes produced by Staphylococcus aureus and various Gram-negative bacteria. It is often used in combination with penicillins to overcome the drug resistance caused by bacterial production of β-lactamase.

Why does Xiaomei use amoxicillin instead of amoxicillin clavulanate potassium?

Acute tonsillitis in children is generally caused by streptococcal infection. Based on the basis of bacterial resistance and epidemiology, amoxicillin is currently more sensitive to streptococci in children, especially those who have not used antibiotics for a long time. The possibility of streptococci producing β-lactamase is low, so amoxicillin granules are more appropriate.

It should be emphasized that antibiotics must be used under the guidance of doctors and pharmacists. Random abuse may induce the production of drug-resistant bacteria.

Don't take medication for granted, read the name and effect of the medicine carefully.

Follow your doctor's orders and ask the pharmacist to ensure safety!

Author: Zhang Zhuo, Chief Pharmacist of the Sixth Division Hospital of Xinjiang Production and Construction Corps

Review expert: Chen Qi, deputy director and pharmacist of the Pharmacy Department of Guizhou Provincial People's Hospital

Wang Baoxin, deputy director and pharmacist of the Pharmacy Department of Peking University First Hospital