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Nisamox (Augmentin)

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Nisamox is a penicillin antibiotic with a notably broad spectrum of activity. The bi-layer tablets provide an immediate release of amoxicillin and clavulanate potassium and an extended release of amoxicillin. This enhanced formulation prolongs the time that bacteria are exposed to the antibiotic and promotes coverage of tough-to-treat S. pneumoniae.

Other names for this medication:
Aclav, Alfoxil, Alphamox, Ambilan, Amimox, Amixen, Amobay, Amobiotic, Amocla, Amoclan, Amoclane, Amodex, Amoklavin, Amoksiklav, Amolin, Amorion, Amotaks, Amoval, Amoxal, Amoxan, Amoxibeta, Amoxicap, Amoxiclav, Amoxidal, Amoxidin, Amoxiduo, Amoxihexal, Amoxiplus, Amoxival, Amoxoral, Amoxsan, Amoxy, Amoxydar, Ampliron, Amylin, Atoksilin, Augmaxcil, Augmentin, Augmex, Augpen, Bactoclav, Betamox, Bioclavid, Biomox, Blumox, Cavumox, Cilamox, Clabat, Clamentin, Clamicil, Clamovid, Clamoxin, Claneksi, Clavam, Clavamel, Clavamox, Clavaseptin, Clavet, Clavinex, Clavipen, Clavobay, Clavubactin, Clavucid, Clavulin, Clavulox, Clavumox, Clonamox, Curam, Dexyclav, Dimopen, Duomox, Enhancin, Exten, Fabamox, Fleming, Fulgram, Germentin, Gimaclav, Gloclav, Glomox, Grinsil, Hiconcil, Himox, Homer, Hymox, Imadrax, Julmentin, Julphamox, Kesium, Klamoks, Klavox, Klavunat, Largopen, Macropen, Maxamox, Medoclav, Megamox, Megapen, Moxacil, Moxatag, Moxiclav, Moxilen, Moxilin, Moxypen, Myclav, Mymox, Natravox, Neomox, Noprilam, Noroclav, Novaclav, Novamox, Novax, Novocilin, Optamox, Oramox, Origin, Panklav, Pediamox, Pinaclav, Pinamox, Ranclav, Ranmoxy, Ranoxyl, Rapiclav, Ronemox, Sulbacin, Suprapen, Synulox, Topcillin, Trifamox, Ultramox, Unimox, Vetrimoxin, Vulamox, Xiclav, Zoxil

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Also known as:  Augmentin.


Nisamox is a brand name for an antibiotic, called co-amoxiclav, that is used to treat a wide range of conditions, from bronchitis to Lyme disease. It is one of the most commonly prescribed antibiotics for children, frequently dispensed for ear infections.

The drug is a combination of two active ingredients: amoxicillin and clavulanic acid. Together, the drugs fight bacteria that would ordinarily be resistant to amoxicillin alone.


Neonates and Infants: The recommended dose of Nisamox is 30 mg/kg/day divided every 12 hours, based on the amoxicillin component. Experience with the 200 mg/5 mL formulation in this age group is limited, and thus, use of the 125 mg/5 mL oral suspension is recommended.

Patients Aged 12 weeks (3 months) and Older: See dosing regimens provided in Table 1. The every 12 hour regimen is recommended as it is associated with significantly less diarrhea [see Clinical Studies (14.2)]. However, the every 12 hour suspension (200 mg/5 mL and 400 mg/5 mL) and chewable tablets (200 mg and 400 mg) contain aspartame and should not be used by phenylketonurics.

Patients Weighing 40 kg or More: Pediatric patients weighing 40 kg or more should be dosed according to adult recommendations.

The 250-mg tablet of Nisamox should not be used until the child weighs at least 40 kg,due to the different amoxicillin to clavulanic acid ratios in the 250-mg tablet of Nisamox (250/125) versus the 250-mg chewable tablet of Nisamox (250/62.5).


If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.


Store between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Keep bottle closed tightly. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Nisamox are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterials, including Nisamox. These reactions are more likely to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens. Before initiating therapy with Nisamox, careful inquiry should be made regarding previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens. If an allergic reaction occurs, Nisamox should be discontinued and appropriate therapy instituted.

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The aim was to study the pharmacodynamics of cefditoren, amoxicillin/clavulanic acid and cefuroxime against mixed Haemophilus influenzae strains.

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The roles of beta-lactamase and alterations in penicillin-binding protein in the development of amoxicillin and amoxicillin/clavulanate resistance in two beta-lactamase-positive, amoxicillin/clavulanate-resistant (BLPACR) strains of Haemophilus influenzae were investigated. Seven beta-lactamase-negative, ampicillin-resistant (BLNAR) strains were also studied for comparison of their resistance mechanisms. All strains had been recovered from patients in Japan. The TEM type beta-lactamase of the two BLPACR strains had 100% homology with the amino acid sequences of published TEM-1 beta-lactamase, showing that amoxicillin/clavulanate resistance was not associated with mutations in this beta-lactamase. However, these strains, as well as the seven BLNAR strains, had multiple mutations in ftsI, which encodes penicillin binding protein 3 (PBP3). The transformation of H. influenzae Rd strain with amplified ftsI genes from two BLPACR and two BLNAR strains enabled the selection of amoxicillin/clavulanate-resistant transformants with the same mutations as their parent strains. We concluded that amoxicillin/clavulanate resistance in the two BLPACR strains was due to changes in PBP3. The possibility of the presence of an extended spectrum beta-lactamase was excluded in the BLPACR strains studied.

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One hundred adult patients with acute sinusitis were included in an open, randomized study. Clinical diagnosis of sinusitis was confirmed by nasal endoscopy, sinus radiography, and (when possible) by culture of sinus aspirate. Patients were randomized to receive azithromycin (500 mg once daily for 3 days) or amoxicillin/clavulanate (625 mg every 8 hours for 10 days).

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Since 2006, ESBL strains have been increasing, and the presence of ESBL showed more detrimental effects on the clinical course of the patients, resulting in a higher rate of progression to chronic prostatitis.

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Resistance of bacteria to antibiotics and disinfectants has been reported widely in the world. Listeria monocytogenes is no exception, although normally it tends to be variably sensitive to many antibiotics and disinfectants.

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433 children, aged 6 months to 6 years, with OME from 57 general practices entered a 3-month watchful waiting period. Of 223 (52%) with persistent bilateral OME, 162 were randomised double-blind to receive co-amoxiclav suspension (20 mg/kg amoxicillin, 5 mg/kg clavulanate potassium) or matching placebo, orally three times a day for 14 days. All cases also received xylometazoline 0.25% decongestant nosedrops thrice daily. Of the 61 not randomised, 13 children were referred to an ENT surgeon and parents refused consent in 48 cases. The main outcome measures were persistent OME in both ears and in one or both ears, as assessed clinically and by tympanometry. Analysis was by intention-to-treat.

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We included 22 trials, involving 6872 women and babies.The use of antibiotics following PROM is associated with statistically significant reductions in chorioamnionitis (average risk ratio (RR) 0.66, 95% confidence interval (CI) 0.46 to 0.96, and a reduction in the numbers of babies born within 48 hours (average RR 0.71, 95% CI 0.58 to 0.87) and seven days of randomisation (average RR 0.79, 95% CI 0.71 to 0.89). The following markers of neonatal morbidity were reduced: neonatal infection (RR 0.67, 95% CI 0.52 to 0.85), use of surfactant (RR 0.83, 95% CI 0.72 to 0.96), oxygen therapy (RR 0.88, 95% CI 0.81 to 0.96), and abnormal cerebral ultrasound scan prior to discharge from hospital (RR 0.81, 95% CI 0.68 to 0.98). Co-amoxiclav was associated with an increased risk of neonatal necrotising enterocolitis (RR 4.72, 95% CI 1.57 to 14.23).One study evaluated the children's health at seven years of age (ORACLE Children Study) and found antibiotics seemed to have little effect on the health of children.

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Females were particularly prone to have confirmed cases of UTI. Escherichia coli were the principle aetiological agent accounting for 61.7% of the isolates. Other bacterial agents were Enterobacter agglomerans (18.7%), Citrobacter diversus (4%), Klebsiella pneumoniae (3.3%), Proteus spp. (2.1%), Pseudomonas spp. (0.1%), Staphylococcus saprophyticus (9.3%), and Streptococcus feacalis (0.7%). Over 60% of the Gram negative bacterial isolates were resistant to cotrimoxazole and ampicillin, 39% resistant to augmentin and 25% were resistant to nalidixic acid. The ceftazidime was the most efficacious antimicrobial with an Escherichia coli resistance level of 2.2% (P=0.05). Resistance to nitrofuraintoin, gentamicin, cefuroxime, norfloxacin and ciprofloxacin was demonstrated in less than 15% of the bacterial isolates.

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The recent information on the appearance of erythema migrans despite prophylaxis with 200 mg of doxycycline was the stimulus for a search among our patients for those who developed the skin lesion regardless of receiving antibiotics after a tick bite.

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Amoxicillin/clavulanate 2000/125 mg was generally well tolerated. This new amoxicillin/clavulanate formulation provides a suitable option for empiric therapy for ABRS in adults.

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Single interventional case report.

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Since liver damage to amoxicillin-clavulanic acid appears to be infrequent, this adverse effect is probably not caused by amoxicillin alone. The risk of liver damage to amoxicillin-clavulanic acid is highest in elderly patients treated with the combination on several occasions. Doctors should restrict the use of this combination to the treatment of infections with amoxicillin-resistant bacteria.

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nisamox 250mg tablets 2015-11-30

We present the case of an 8-year-old patient after liver transplantation who developed drug induced liver injury (DILI) after amoxicillin/clavulanic acid treatment for upper respiratory tract infection. Jaundice appeared 2 days after cessation of treatment. Clinical presentation and liver biopsy were consistent with DILI. Because of rapidly increasing bilirubin levels, we used 3 boluses of methylprednisolone and ursodeoxycholic acid. The treatment reversed progression of the cholestasis and full recovery was achieved in 3 Clavipen 500 Mg Dosis months.

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This study demonstrated that A-CA exhibited the lowest bacterial resistance for clinical isolates in Hemomycin 500 Mg Tablete primary dentition infections.

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There is wide variation in UK prescribing practice regarding prophylactic antibiotics for nasal packing in spontaneous epistaxis. There Cepodem 200 Breastfeeding are few published cases of infective complications in such patients.

nisamox tablets 250mg 2015-01-16

Actinomycosis is a rare chronic granulomatous disease that involves the upper airway and gastrointestinal tract. Approximately 40-55% of actinomycosis comprises the cervicofacial form. It presents a challenging clinical diagnostic dilemma because of variable presentations in the head and neck. Herein, we report a rare case of actinomycosis Azithromycin 500 Mg And Alcohol presenting as a vocal cord nodule in a healthy 21-year-old man who was not immunocompromised and had no other known medical disease.

nisamox dose chart 2015-08-18

In the present study, the antibiotic susceptibility of most prevalent micro-organisms in advanced periodontitis patients was evaluated. In 56 patients, pooled subgingival plaque samples were taken from the deepest site of each quadrant and were cultivated anaerobically. From each patient, the 4 most frequently encountered types of bacterial colonies were subcultured and identified (Rapid ID 32 A). From all bacterial species identified in the 224 subcultures, the 4 most prevalent were used for susceptibility testing to tetracycline, metronidazole and amoxicillin/clavulanate using the E Test. The most prevalent microorganisms were Fusobacterium nucleatum (38/214), Peptostreptococcus micros (33/214), Prevotella oralis (33/214 Nolicin Antibiotic Pret ) and Porphyromonas gingivalis (32/214). Regarding antibiotic susceptibility it could be shown that minimal inhibitory concentration (MIC) in all cases was below antibiotic concentrations achievable in gingival crevicular fluid. However, antibiotic resistance was seen in 3 to 29% of the investigated microorganisms.

nisamox antibiotics 2016-03-14

Bronchiectasis unrelated to cystic fibrosis (CF) is being increasingly recognized in children and adults globally, both in resource-poor and in affluent countries. However, high-quality evidence to inform management is scarce. Oral amoxycillin-clavulanate is often the first antibiotic chosen for non-severe respiratory exacerbations, because of the antibiotic Ampliron Duo Alcohol -susceptibility patterns detected in the respiratory pathogens commonly associated with bronchiectasis. Azithromycin has a prolonged half-life, and with its unique anti-bacterial, immunomodulatory, and anti-inflammatory properties, presents an attractive alternative. Our proposed study will test the hypothesis that oral azithromycin is non-inferior (within a 20% margin) to amoxycillin-clavulanate at achieving resolution of non-severe respiratory exacerbations by day 21 of treatment in children with non-CF bronchiectasis.

nisamox 250 dosage 2015-08-18

Successful closure of thermal injuries, by either skin graft or delayed wound closure, largely depends on the ability to control the number of bacteria in the wound. The purpose of this study was to investigate the efficacy of two new antimicrobial agents, ticarcillin and clavulanate (Timentin) and amoxicillin and clavulanate (Augmentin), in the infected thermal injury. The therapeutic results were compared with the model treated with the standard topical silver sulfadiazine (Silvadene). Seventy-six Sprague-Dawley rats received a 20% full-thickness thermal injury and were then divided into six treatment groups. Three of the groups were inoculated topically with 10(8) Pseudomonas aeruginosa/ml, and three of the groups received topical inoculation of 10(8) Staphylococcus aureus/ml. The groups inoculated with P. aeruginosa received either intraperitoneal Timentin, topical Silvadene, or placebo treatment. The groups inoculated with S. aureus were treated with either enteral Augmentin, topical Silvadene, or placebo. The animals received 10 days of therapy and underwent tissue biopsies on alternate days. Statistical analysis showed that the level of bacteria in the wounds compared with the control group was significantly (p less than 0.05) decreased for both antibiotics tested as measured by quantitative wound biopsies. These studies demonstrate the efficacy Novocilin 250 Mg of systemic Timentin and Augmentin in the infected thermal injury.

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After symptomatic treatment with Colestyramine (4 g three times Rulid Antibiotic daily), ursodeoxycholic acid (250 mg twice daily) and the antihistaminic Clemastine (1 g two times daily) the severe pruritus decreased quickly and alkaline phosphatase concentration became normal. At follow-up examination 4 and 8 weeks later the laboratory tests were normal.

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The aim of this prospective study was to compare the efficacy of oral versus parenteral prophylactic amoxicillin-clavulanic acid for preventing surgical site infection after open prosthetic mesh repair of inguinal hernia. A total of 480 inguinal-hernia patients were randomly assigned to two groups. Group I (n = 240) received 1.313 g oral amoxicillin-clavulanic acid 2 hours before operation, and group II (n = 240) received 1.2 g of the same drug combination intravenously approximately 30 minutes before surgery. Patients were examined four times during 1 year of follow-up (at 7-10 days, 4-6 weeks, 6 months, and 12 months postoperation), and data related to surgical site infections were collected. Seventy-two patients were excluded due to confounding factors during and after the operation. There were no statistically significant differences between group I (final n = 208) and group II (final n = 200) with respect to age, sex distribution, body mass index, American Anesthesiology Association grade, frequencies of different hernia types, duration of surgery, and the experience levels of the principal surgeon in the operations. One of the 208 (0.5%) patients in group I and 3 of the 200 (1.5%) patients in group II developed superficial surgical site infections (p > 0.05). None of the infections required mesh removal. There were no deep surgical site infections in either group, and there was one case of hernia recurrence in each group. For patients undergoing open prosthetic repair of inguinal hernia, oral amoxicillin-clavulanic acid is safe, significantly less costly, and equally effective in preventing surgical site infection as the same dose given parenterally.

nisamox 50mg tablets dogs 2016-10-27

Bolivia is not an exception to the very high resistance burden affecting many South American countries. Optimization of alternative approaches to monitor local antibiotic resistance trends in resource-limited settings is strongly encouraged to support the implementation of effective empiric treatment guidelines.

nisamox tablets side effects 2016-06-02

Fever and pneumonia initially improved but 64 (85%) patients developed recurrent fever after a mean of 8.9 (SD 3.1) days, 55 (73%) had watery diarrhoea after 7.5 (2.3) days, 60 (80%) had radiological worsening after 7.4 (2.2) days, and respiratory symptoms worsened in 34 (45%) after 8.6 (3.0) days. In 34 (45%) patients, improvement of initial pulmonary lesions was associated with appearance of new radiological lesions at other sites. Nine (12%) patients developed spontaneous pneumomediastinum and 15 (20%) developed acute respiratory distress syndrome (ARDS) in week 3. Quantitative reverse-transcriptase (RT) PCR of nasopharyngeal aspirates in 14 patients (four with ARDS) showed peak viral load at day 10, and at day 15 a load lower than at admission. Age and chronic hepatitis B virus infection treated with lamivudine were independent significant risk factors for progression to ARDS (p=0.001). SARS-associated coronavirus in faeces was seen on RT-PCR in 65 (97%) of 67 patients at day 14. The mean time to seroconversion was 20 days.