THE EFFICACY OF AMOXICILLIN-CLAVULANATE (AUGMENTIN(R)) IN THE TREATMENT OF SEVERE STAPHYLOCOCCAL INFECTIONS

The experimental and clinical values of amoxycillin/clavulanate in sev ere Staphylococcus aureus infections are reviewed. Experimentally, amo xycillin/clavulanate was highly effective in the treatment of acute en docarditis due to methicillin-sensitive isolates of S. aureus (MSSA) i n rats. In addition, high doses of amoxycillin/clavulanate also cured experimental endocarditis due to methicillin-resistant strains of S. a ureus (MRSA) in the animal model. In the clinical setting, a review of 86 patients with either community- or hospital-acquired bacteraemia d ue to MSSA showed that intravenous treatment with amoxycillin/clavulan ate was adequate for empirical (and apparently also long-term) therapy of such severe infections. However, the retrospective nature of the a nalysis did not allow assessment of the relative efficacy of amoxycill in/clavulanate as compared with standard anti-staphylococcal drugs, su ch as flucloxacillin or vancomycin. Further prospective studies are wa rranted to address this issue. Thus, amoxycillin/clavulanate appears t o be a good candidate for empirical treatment of severe infections tha t may be caused by MSSA. Usage of amoxycillin/clavulanate against MRSA is, however, still experimental and is not currently advocated for th e treatment of MRSA infections in humans.