The Action of Amoxicillin-Clavulanate on Hepatocytes

Abstract

The oral antibiotic amoxicillin is third generation penicillin combined to clavulanate, widely employed in medicine and dentistry for treatment of mild-to-moderate bacterial infections. Clavulanate is not indicated alone because it lacks antibacterial activity, so it is added to amoxicillin in order to inactivate beta-lactamse enzyme which is the major cause of penicillin resistance. Beta- lactamase is produced by many microorganisms, it destroys beta lactam ring of beta lactam antibiotics, therefore amoxicillin-clavulante is indicated as an extended antibiotic that covers many gram positive a and a significant number of gram negative microorganisms which produce beta-lactamse. This compound amoxicillin-clavulanate is available in multiple dose variations, typically as 250, 500 to 875 mg amoxicillin with 125 mg of clavulanate potassium, given two to three times daily for 7 to 10 days. The combination is provided in many trade formulation namely moclav and agumentin. Amoxicillin is in general use because it is the most effective and least toxic antibiotic, however it can cause some unwanted effects particularly allergic, GIT and renal effects. The purpose of recent study is to estimate possibility toxic effect of amoxicillin-clavulanate on hepatocytesand its revesibility, about 64 infectious patients of several ages were investigated, 35 of them are men and the 29 are women, for about 3 weeks. Complete blood count (CBC) and serum of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (AP) and gamma glutamyltranspeptidase (gamma-GT) are taken before, and after completion of treatment. The main finding of this research is that amoxicillin-clavulanate has a toxic effect on hepatocytes, represented mainly by reversible cholestatic hepatitis in patients older 50 years, who experience fatigue, GIT upset, prurituts and jaundice. The hepatic injury has occurred in elderly men more than in women.