Co-amoxiclav 625mg (COPD Exacerbation / CAP)

How it works

Amoxicillin inhibits bacterial cell-wall synthesis, while clavulanic acid protects it from breakdown by beta-lactamase enzymes, extending activity to many resistant respiratory organisms. The pairing restores efficacy against beta-lactamase-producing strains.

Prescribing in practice

• Contraindicated in penicillin hypersensitivity and in anyone with a history of co-amoxiclav- or penicillin-associated jaundice or hepatic dysfunction, as the clavulanate component carries a distinct risk of cholestatic liver injury.
• Use cautiously in significant hepatic impairment and reduce the dose in renal impairment per current prescribing references.
• Counsel on Clostridioides difficile risk with this broad-spectrum agent and avoid unnecessary use.

Monitoring

Monitor for hepatic effects (especially on longer courses or in older patients), clinical response, and any new diarrhoea suggestive of C. difficile.

Counselling the patient

• Take with food to reduce stomach upset and complete the course.
• Report jaundice, dark urine, or persistent watery or bloody diarrhoea.
• Tell your prescriber about any penicillin or antibiotic allergy.

Evidence & guidelines

NICE guidance on COPD exacerbations and pneumonia lists co-amoxiclav among antibiotic options, generally for more severe disease or when first-line agents are unsuitable.