Augmentin ES-600 (Amoxicillin/Clavulanate) in Kenya: Product Description

Product Overview

Augmentin ES-600 is an oral suspension containing:

• Amoxicillin (600mg per 5ml) – a penicillin antibiotic.
• Clavulanate Potassium (42.9mg per 5ml) – a β-lactamase inhibitor.

It is a high-potency formulation used to treat severe bacterial infections in children, particularly:

• Recurrent/persistent otitis media (middle ear infections).
• Sinusitis (maxillary or ethmoid).
• Community-acquired pneumonia (CAP).
• UTIs (complicated or resistant).

In Kenya, Augmentin ES is reserved for infections unresponsive to standard antibiotics due to its enhanced coverage against β-lactamase-producing bacteria (e.g., H. influenzae, M. catarrhalis).

Key Advantages:

• 4:1 amoxicillin:clavulanate ratio – optimized for resistant pathogens.
• Twice-daily dosing (improves compliance).
• Bioequivalent to IV amoxicillin/clavulanate in severe cases.

Frequently Asked Questions (FAQs)

1. What makes Augmentin ES different from regular Augmentin?

   • Higher amoxicillin dose (600mg/5ml vs. 400mg/5ml in DT).
   • Lower clavulanate (42.9mg/5ml vs. 57mg/5ml in DT) – reduces diarrhea risk.
   • For severe/resistant infections only – not for mild cases.

2. Is Augmentin ES available in Kenya?

   • Yes, in:
     • Pediatric hospitals: Gertrude’s Children’s Hospital, Nairobi Hospital.
     • Major pharmacies: Goodlife, Medsafes, Cintas Pharma (refrigerated section).
   • Cost: ~KES 1,500–2,500 per 75ml bottle (reconstituted).

3. Can adults use it?

   • No – pediatric formulation only. Adults use Augmentin 1g tablets or IV.

4. What are the side effects?

   • Common: Diarrhea (10–20% of cases), nausea, rash.
   • Serious (seek help):
     • Severe allergic reaction (anaphylaxis – facial swelling, breathing trouble).
     • Clostridioides difficile infection (watery/bloody diarrhea).
     • Liver toxicity (jaundice, dark urine).

5. Does NHIF cover Augmentin ES?

   • Yes, under “Supa Cover” for pediatric infections. Requires pediatrician’s prescription + infection severity documentation.

How to Use Augmentin ES-600

• Dosing (Children):

  Weight	Dose	Frequency
  8–12 kg	5ml (600mg)	Every 12 hrs
  13–19 kg	7.5ml (900mg)	Every 12 hrs
  20–29 kg	10ml (1,200mg)	Every 12 hrs
  ≥30 kg	12.5ml (1,500mg)	Every 12 hrs

  • Max Duration: 10–14 days (unless directed otherwise).

• Reconstitution & Storage:

  1. Add 67ml water to the bottle (shake until powder dissolves).
  2. Refrigerate (2–8°C) after reconstitution.
  3. Discard after 10 days (even if unused).

• Critical Precautions:

  • Take with food – reduces GI upset.
  • Complete full course – even if symptoms improve.
  • Avoid antacids – interfere with absorption.
  • Monitor for diarrhea – give probiotics (e.g., Lactobacillus) 2 hrs apart.

Composition

• Active Ingredients per 5ml:
  • Amoxicillin (as trihydrate): 600mg.
  • Clavulanate Potassium: 42.9mg (equivalent to 30mg clavulanic acid).
• Inactive Ingredients: Xanthan gum, aspartame, colloidal silicon dioxide, orange flavor.
• Packaging: 75ml powder for oral suspension (with dosing syringe).

Conclusion

Augmentin ES-600 is a critical tool for Kenyan pediatricians combating resistant bacterial infections, offering high-dose amoxicillin with minimized clavulanate side effects. Its efficacy in recurrent otitis media and pneumonia makes it indispensable, but judicious use is vital to preserve antibiotic efficacy.

Access & Best Practices in Kenya:

1. Prescription Path:
   • Diagnosis: Confirm infection severity via culture/sensitivity at KEMRI or Lancet Labs (cost: ~KES 3,000–5,000).
   • Pediatrician Referral: Required for ES-600 (retail pharmacies may refuse without specialist note).
2. Cost Management:
   • NHIF: Submit pediatrician’s prescription + lab reports.
   • Generics: Amoclav ES-600 (Dawa Ltd) – ~KES 1,200–1,800 (equivalent efficacy).
3. Storage Solutions:
   • Use insulated cooler bags (KES 500–1,000) during transport/power outages.
   • Community Health Centers: Free dispensing at Mbagathi District Hospital (carry NHIF card).

Disclaimer: Not medical advice. Antibiotic misuse risks resistance. Use only under pediatric supervision.