Moxiclav (Amoxicillin, Clavulanic Acid)

Moxiclav is indicated for bacterial infections that involve the respiratory, urinary, skin, sinus, and middle‑ear pathways.

• Respiratory tract infections: effective against common bacterial causes such as streptococci and Haemophilus, helping to resolve cough, sputum and fever.
• Urinary tract infections: eradicates susceptible uropathogens, reducing dysuria and pyuria.
• Skin and soft tissue infections: treats cellulitis, abscesses and wound infections caused by susceptible organisms.
• Sinusitis: clears bacterial sinus inflammation, improving nasal discharge and facial pain.
• Otitis media: eliminates middle‑ear bacterial pathogens, relieving ear pain and hearing impairment.

• Amoxicillin binds to penicillin‑binding proteins, inhibiting the final stages of bacterial cell‑wall peptidoglycan synthesis, which leads to cell lysis. Clavulanic acid acts as a suicide inhibitor of beta‑lactamase enzymes produced by resistant bacteria, protecting amoxicillin from enzymatic degradation and extending its antimicrobial spectrum.

Moxiclav may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Diarrhea: loose stools occurring during therapy.
• Nausea: feeling of stomach upset often accompanied by loss of appetite.
• Rash: mild skin erythema or itching.
• Headache: transient cranial discomfort.

Serious or Rare Side Effects

• Anaphylaxis: severe, potentially life‑threatening allergic reaction with airway compromise.
• Clostridioides difficile‑associated colitis: severe diarrhea due to overgrowth of toxin‑producing bacteria.
• Hepatic injury: elevated liver enzymes or jaundice indicating liver stress.

Before prescribing Moxiclav, clinicians should consider several safety factors.

• Allergy assessment: avoid in patients with known hypersensitivity to penicillins or clavulanic acid.
• Renal function: dose adjustment may be required in severe renal impairment.
• Hepatic function: monitor liver enzymes during prolonged therapy.
• Pregnancy and lactation: use only if the expected benefit justifies potential risk.
• Drug interactions: review concomitant medications for possible interactions.
• Store at below 25°C: keep in the original pack, protect from moisture.

Moxiclav can interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Probenecid: may increase amoxicillin plasma concentrations, raising toxicity risk.
• Methotrexate: can reduce clearance, leading to enhanced toxicity.
• Oral contraceptives: may reduce hormonal efficacy, increasing pregnancy risk.

Moderate Interactions (Monitor Closely)

• Warfarin: may potentiate anticoagulant effect, requiring INR monitoring.
• Allopurinol: may increase the likelihood of skin rash, necessitating observation.