Uses of Fugentin

Fugentin is available as film-coated tablets or as a powder for oral suspension. Its primary ingredients are Amoxicillin trihydrate and Potassium clavulanate. This medication is used to treat various infections, including those in the respiratory tract, bones and joints, and urinary tract, among others.

1. Uses of Fugentin 1000mg

Fugentin 1000mg has the main ingredients: Amoxicillin 875mg and Clavulanic acid 125mg. Amoxicillin is a semi-synthetic penicillin (beta-lactam antibiotic) that inhibits 1 or more enzymes involved in the biosynthesis of peptidoglycan (an essential component of the bacterial cell wall). As a result, the cell wall is weaker, causing the cell to lyse and die. Amoxicillin is easily destroyed by beta-lactamases (produced by resistant strains of bacteria), so these strains of bacteria will not be sensitive to Amoxicillin if used alone.
Clavulanic acid is a beta-lactam structurally related to penicillin, which has the effect of inactivating some beta-lactamase enzymes, preventing Amoxicillin from being inactivated. When used alone, clavulanic acid does not affect killing bacteria.
Indications for using Fugentin: Short-term treatment (less than 14 days) of infections caused by beta-lactamase-producing strains that do not respond to treatment with aminopenicillin alone: ​​

• Severe upper respiratory tract infections: Sinusitis, tonsillitis, otitis media that have been treated with conventional antibiotics but have not improved;
• Lower respiratory tract infections caused by beta-lactamase-producing bacteria: Bronchitis - pneumonia, acute and chronic bronchitis;
• Severe urinary tract infections caused by beta-lactamase-producing bacteria: Urethritis, cystitis, pyelonephritis;
• Skin and soft tissue infections: Abscesses, boils, insect bites, cellulitis, wound infections;
• Bone and joint infections: Osteomyelitis;
• Dental infections: Tooth abscess;
• Other infections: Obstetric infections (due to abortion, miscarriage, obstetric septicemia), infections caused by sensitive bacteria, abdominal infections (peritonitis, intravenous injection in septicemia, prevention of infection during surgery of the stomach - intestines, uterus, heart, kidney, head and neck, joint replacement and biliary tract).

Contraindications to the use of Fugentin 1000mg:

• People who are sensitive to the active ingredient, penicillin or ingredients in the drug;
• People with a history of severe immediate hypersensitivity (anaphylaxis) to any beta-lactam antibiotic (cephalosporin, carbapenem, monobactam);
• Patients with a history of jaundice, and liver failure related to amoxicillin/clavulanic acid.

2. How to use Fugentin

Fugentin is taken orally. Patients should take the medicine immediately before meals to reduce the risk of gastrointestinal intolerance and optimize drug absorption.
For tablets, patients should take the tablet directly with a glass of water. For powdered medicine for oral suspension, mix the amount of powder in each packet with a little water, stir well to dissolve the medicine and drink immediately.

3. Dosage of Fugentin

When selecting the dosage of Fugentin to treat patients with infections, it is necessary to pay attention to:

• The predicted causative agent, its sensitivity to antibiotics;
• The severity and location of the infection;
• The age, weight, and renal function of the patient;
• Consider switching to other preparations that provide higher doses of Amoxicillin or have different ratios of Amoxicillin/Clavulanic Acid if necessary.

For people over 40kg, using Fugentin 1000mg powder for suspension will provide a total daily dose of 1750mg amoxicillin/250mg clavulanic acid if using 2 packets per day; 2625mg amoxicillin/375mg clavulanic acid if using 3 packets per day.
For children under 40kg, using Fugentin powder for suspension will provide the highest daily dose of 1000 - 2800mg amoxicillin/143 - 400mg clavulanic acid when used. If it is considered necessary to use a higher daily dose of amoxicillin, it is recommended to switch to a preparation with a different ratio of amoxicillin/clavulanic acid.
The duration of treatment will depend on the patient's response to Fugentin. For some infections, a longer treatment period may be required (eg osteomyelitis). Normally, Fugentin should not be used for more than 14 days without reviewing the treatment.
Dosage for the following groups of subjects:

• People over 40kg: The standard dose for all indications is 1 packet/time x 2 times/day. Higher doses (indicated for sinusitis, otitis media, lower respiratory tract infections, urinary tract infections) are 1 packet/time x 3 times/day;
• Children under 40kg: The recommended dose is 25mg/3.6mg/kg/day - 45mg/6.4mg/kg/day, divided into 2 times/day. Can use a dose of up to 70mg/10mg/kg/day, divided into 2 times/day when treating some diseases such as otitis media, sinusitis or lower respiratory tract infections;
• Elderly: No need to adjust the dose of Fugentin 1000mg;
• Patients with kidney failure: If creatinine clearance is above 30ml/minute, no need to adjust the dose. Do not use amoxicillin/clavulanic acid 7:1 in patients with creatinine clearance below 30ml/minute;
• Patients with liver failure: Use Fugentin with caution, liver function should be monitored periodically.

Overdose: When taking an overdose of Fugentin, the patient will have symptoms of abdominal pain, vomiting and diarrhea, rash, increased agitation, drowsiness, etc. The treatment is to stop taking the drug immediately, treat symptoms and provide supportive treatment if necessary. If the overdose occurs early, without contraindications, vomiting or gastric lavage may be induced. If the overdose is less than 250 mg/kg, there is no special symptom, there is no need to clean the stomach. Interstitial nephritis leads to kidney failure, and oliguria occurs in some patients who overdose on amoxicillin. Some people have crystalluria, leading to kidney failure. It is necessary to provide enough water and electrolytes to the body to maintain urination, reducing the risk of crystalluria. After stopping the drug, kidney damage usually recovers. Hypertension can occur in patients with impaired renal function due to reduced excretion of amoxicillin and clavulanic acid, so hemodialysis can be used to remove the drug from the circulatory system. 
Missed dose: If you miss a dose of Fugentin, you should take it as soon as possible. If it is close to the next dose, you can skip the missed dose of Fugentin and take the next dose at the scheduled time.

4. Side effects of Fugentin

When using Fugentin, you may experience some side effects such as:

• Common: Candida infection on the skin and mucous membranes, nausea, vomiting, diarrhea;
• Uncommon: Dizziness, headache, indigestion, increased AST and ALT, rash, itching, hives on the skin;
• Rare: Thrombocytopenia, reversible leukopenia, erythema multiforme;
• Frequency unknown: Overgrowth of non-susceptible bacteria, hemolytic anemia, reversible agranulocytosis, prolonged bleeding time and prothrombin time, angioneurotic edema, anaphylaxis, hypersensitivity vasculitis, serum sickness-like syndrome, reversible hyperkinesia, aseptic meningitis, seizures, hepatitis, cholestatic jaundice, black hairy tongue, tooth discoloration, antibiotic-associated colitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, exfoliative bullous dermatitis, acute generalized exanthematous pustulosis, crystalluria, interstitial nephritis.

When experiencing side effects of Fugentin, patients should stop taking the drug and immediately notify the doctor or go to the nearest hospital for timely examination and treatment.

5. Precautions when using Fugentin

Before and while using Fugentin 1000mg, patients should note:

• Inform the doctor if there is a history of hypersensitivity to penicillin, cephalosporin or beta-lactam antibiotics;
• There have been cases of patients experiencing severe hypersensitivity reactions, sometimes fatal (anaphylactic) when treated with penicillin. These reactions often occur in people with a history of hypersensitivity to penicillin and a history of allergy. If this reaction occurs, the patient should stop treatment with Fugentin and switch to another appropriate alternative therapy;
• In cases where the infection is proven to be caused by bacteria sensitive to amoxicillin, it may be considered to switch from Fugentin treatment to amoxicillin alone;
• Fugentin is not suitable if there is a high risk of infection with strains of bacteria that are less sensitive or resistant to beta-lactam antibiotics, leading to the inhibitory effect of the clavulanic acid component. Do not use Fugentin to treat diseases caused by penicillin-resistant pneumococci;
• Patients with kidney failure or taking high doses of Fugentin may have seizures;
  Avoid treatment with Fugentin in cases of suspected infectious mononucleosis due to the appearance of a measles-like rash after using amoxicillin;
• Concomitant use of allopurinol when treating with amoxicillin may increase the risk of skin allergies;
• Prolonged use of Fugentin 1000mg may lead to overgrowth of bacteria that are not sensitive to the drug;
• If a patient taking Fugentin develops a generalized rash and fever with pustules, it may be a symptom of acute generalized exanthematous pustulosis. The patient should stop treatment, and amoxicillin is contraindicated in the future;
• Be careful when using Fugentin in patients with liver failure, and adjust the dose accordingly. Common liver events may be related to prolonged use;
• Antibiotic-associated colitis has been reported with the use of antibiotics, including amoxicillin. Therefore, consider this condition when using Fugentin if the patient develops diarrhea with any antibiotic. If antibiotic-associated colitis occurs, treatment with Fugentin should be discontinued and the physician should be notified so that appropriate therapy can be initiated. Drugs that decrease intestinal motility are contraindicated in this situation;
• Periodic liver, renal, and hematopoietic function tests should be performed during long-term use of Fugentin;
• There have been cases of prolonged prothrombin time in patients treated with Fugentin. Appropriate monitoring is recommended if Fugentin is prescribed concomitantly with anticoagulants. The dose of oral anticoagulants may be adjusted if necessary to maintain the desired drug concentration;
• Crystallinuria has been reported in oliguria (mainly with parenteral therapy). When using high doses of amoxicillin, patients should drink enough water and maintain urine output to reduce the risk of crystalluria. In patients using urinary catheters, it is necessary to regularly check to ensure that the catheter is not blocked;
• During treatment with amoxicillin, the enzyme glucose oxidase method should be used if testing for glucose in urine is desired because non-enzymatic methods may give false positive results;
• In Fugentin 1000mg, the ingredient clavulanic acid can cause IgG and albumin to bind non-specifically to the red blood cell membrane, causing false positive results in the Coombs test;
• Fugentin oral suspension powder contains 12.5 mg of aspartame (a source of phenylalanine), so caution should be exercised when using the drug in patients with phenylketonuria;
• Do not use Fugentin in children under 2 months of age;
• Fugentin can cause dizziness and headache, so caution should be exercised when driving or operating machinery;
• Avoid using Fugentin in pregnant and lactating women, if necessary, with a doctor's prescription.

6. Fugentin drug interactions

Some Fugentin drug interactions that patients need to pay attention to include:

• Oral anticoagulants: There have been cases of increased INR in patients using acenocoumarol or warfarin, concurrently with amoxicillin. If it is necessary to combine drugs, prothrombin time or INR should be closely monitored when increasing the dose or stopping amoxicillin. However, the dose of oral anticoagulants may need to be adjusted;
• Methotrexate: Penicillins reduce methotrexate excretion, increasing the risk of toxicity;
• Probenecid: It is not recommended to use probenecid with Fugentin at the same time because probenecid reduces the renal tubular excretion of amoxicillin. Concomitant use of the two drugs increases and prolongs the concentration of amoxicillin in the blood;
• Mycophenolate Mofetil: In patients being treated with mycophenolate mofetil, there is a decrease in pre-dose concentration of the active metabolite mycophenolic acid by about 50% after using oral amoxicillin in combination with clavulanic acid. Closely monitor the patient's health when combining drugs.

When using Fugentin, patients should inform their doctor about their medical history and the medications they are taking for advice, to avoid drug interactions or dangerous events to their health and life. At the same time, if any side effects occur, the patient should promptly notify the doctor for appropriate and timely treatment.

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