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» LymeNet Flash » Questions and Discussion » Medical Questions » Augmentin with amoxy....why?

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Author Topic: Augmentin with amoxy....why?
twinnick
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I am prepping myself to switch over to amoxy in about a week. I looked at my LLMD's handout and he wants me to take augmentin with it.

What does augmentin do? Does it do the same thing as probencid...or whatever it is that Dr B recommends taking in conjunction with amoxy?

Thanks all!

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'Kete-tracker
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All I've ever read is that you can't take the Augmentin by *itself* & get up to the recommended oral levels of amoxicillun (3 - 4gr/day) without exceeding the safe amount of 'clavulanate potassium', the "added" drug in Augmentin.

I know of no medical literature that suggests the clavulanate helps fight the Lyme, but who knows!

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twinnick
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So....what does augmentin do? I'm confused.
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TF
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Quotes from Burrascano regarding Augmentin:

"Because of its short half-life and need for high levels, amoxicillin is usually administered along with probenecid. An extended release formulation of amoxicillin+clavulanate (“Augmentin XR”) may also be considered if adequate trough levels are difficult to attain." (page 14)


ORAL THERAPY: Always check blood levels when using agents marked with an *, and adjust dose to achieve a peak level above ten and a trough greater than three. Because of this, the doses listed below may have to be raised. Consider Doxycycline first in early Lyme due to concern for Ehrlichia co-infections.

*Amoxicillin- Adults: 1g q8h plus probenecid 500mg q8h; doses up to 6 grams daily are often needed" (page 18)

*Augmentin- Standard Augmentin cannot exceed three tablets daily due to the clavulanate, thus is given with amoxicillin, so that the total dose of the amoxicillin component is as listed above for amoxicillin. This combination can be effective when Bb beta lactamase is felt to be significant. (page 18)


http://www.ilads.org/lyme_disease/B_guidelines_12_17_08.pdf

These quotes give a little insight.

The Augmentin helps the patient have the trough (lowest level of medication that occurs between doses) level needed for adequate therapy with amoxicillin.

If your level of medication gets too low between dosages (the "trough" gets too low), the medication will not be effective. So, taking Augmentin along with amoxicillin will help prevent this from happening.

Your peak level of amoxi is achieved shortly after you take it. Then, the level begins falling. It hits the trough right before you take the next dose of med.

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twinnick
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So does it do the same thing as probenecid? I'm still a bit confused haha. I'm just trying to decide if I need to call my LLMD to get a script for probenecid or if augmentin does the same thing...

Thanks for all the info thus far!

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twinnick
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Well,

I think I am going to forgo the probenecis as it sounds like the augmentin is meant to do the same thing...

Let me know if I am reading this wrong.

Thanks all!

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aMomWithHope
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From what my understanding is, which could be totally wrong, so take it for what it's worth....

In order to achieve the high levels of dosage that Dr. B suggests, you need to take both Augmentin and Amoxicillin --

Probenecid increases the effectiveness of Amoxicillin -- but too much probenecid would be dangerous

[ 03-19-2014, 01:12 PM: Message edited by: aMomWithHope ]

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'Kete-tracker
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I don't believe clavulanate [potassium] & Probenecid are the same thing, aMom.

Clavulanate is a "beta-lactamase inhibitor" that increases the effectiveness of the amoxicillun when fighting certain *other* bacteria, like Staphylococcus aureus (a type of Staph infection) & Haemophilus influenzae (a type of flu which can result in pneumonia).

I know of no advantage of adding clavulanate if targeting Borrelia Burgdorferi (Lyme).

---
"Probenecid" [4-(dipropylsulfamoyl)benzoic acid] is a drug that affects bladder function, increasing secretion of uric acid in the urine. From Wiki:
"Probenecid was developed as an alternative to caronamide[1] to competitively inhibit renal excretion of some drugs, thereby increasing their plasma concentration and prolonging their effects."

& That's what it does when using it with the amoxicillun to fight Lyme disease! [Smile] It keeps the "amoxy" in the blood longer, allowing 2 doses a day vs. the typical 3.
Hence, less overall amoxy is needed! (cheeper)

Only issue is, some folks are allergic to Probenecid, a Sulfa class drug... about 5-8% of us. [Frown]
Also, don't take aspirin (a "salicylate") with Probenecid. They are incompatible.

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twinnick
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Ugh...now I am confused again.

So augmentin does little, if anything, against Lyme?

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TF
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twinnick, read the Burrascano quotes I gave you. Go to the document itself and read the quotes from the document.

Augmentin is listed in the Burrascano Lyme Treatment Guidelines as a drug to treat lyme diease.

It is prescribed along with amoxi to achieve the correct dose of amoxi.

You should be able to see that in the quotes. I don't see any issue with what your lyme doctor is prescribing.

Try to study the Burrascano Guidelines. When you have the document on the screen, you can use the "find" function (Control+f) to find the word "augmentin" and read everything Burrascano says about it.

This is an easy way to find answers to all of your questions any time, day or night. Just type in a key word and then read, read, read.

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aMomWithHope
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Thanks, Kete.

This was interesting to learn.

Both my children are allergic to Augmentin, and we thought it was due to the Amoxicillin, but now I'm wondering if it is instead the probenecid (sulfa) --

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TF
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aMom, Augmentin doesn't have probenecid in it. It has clavulanate.

So, the only 2 ingredients in Augmentin are amoxi and clavulanate.

A poster above may have gotten her words mixed up.

If you just take amoxi, then you have to take probenecid with it to keep it in your bloodstream longer.

If you take Augmentin, then you just take Augmentin and amoxi.

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aMomWithHope
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Yes, TF, you are correct about that -- thanks for clarifying that.

(I thought that was the case but got confused when both clavulanate and Probenecid were written about above.)

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'Kete-tracker
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Easy to confuse these additives. [Wink]

Yup... Probenecid- though originally used to treat gout- is good at maintaining levels of any of the penicilluns in the blood.
I had no issues with it, though a few may experience headache, nausea & or dizziness.
(It isn't found in Augmentim.)

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Thewino
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For the record: There is plain Amoxicillin then there is Augmentin.

Augmentin has the potassium salt, clavulanate potassium added to the Amoxicillin. When this potassium salt is added, it Augments (makes stronger) the Amoxicillin dosage.

Probenecid is a totally different medication.

I hope this helps.

Regards,
TheWino

--------------------
Wrinkles only go where the smiles have been --J. Buffett

All of my replies should not be taken as medical advice as they are my opinions only and I am not a physician.

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