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Clavulanic acid is a medication that can be used in conjunction with amoxicillin to manage and treat bacterial infections, specifically bacteria that are beta-lactamase producers. It is in the beta-lactamase inhibitor class of medications. This activity describes the indications, action, and contraindications for clavulanic acid as a valuable agent in the treatment of beta-lactamase-producing bacterial infections when used with amoxicillin and how the interprofessional team can use this agent to drive positive outcomes in fighting infections. Objectives: Identify the mechanism of action of clavulanic acid. Describe the potential adverse effects of clavulanic acid. Outline the appropriate monitoring for patients receiving clavulanic acid. Review interprofessional team strategies for improving care coordination and communication to advance clavulanic acid and improve outcomes. Access free multiple choice questions on this topic.

The toxicity of clavulanic acid alone is unknown. However, the toxic effects of amoxicillin/clavulanate have been reported. The most common toxic effect is an idiosyncratic drug-induced hepatic injury which leads to a mixed hepatocellular-cholestatic injury, and it is more common in older men.[9] Amoxicillin-clavulanic acid is the most common cause of idiosyncratic drug-induced hepatic injury.[11] Risk factors for hepatic injury include sex, cytochrome P450, and genetic polymorphisms. These risk factors should be examined before administering amoxicillin/clavulanate to reduce the risk of toxic and adverse effects.[12] In addition to early diagnosis and discontinuation of the drug, N-acetylcysteine can be administered to minimize damage.[13] Additionally, steroids can be given to decrease the time it takes to return hepatic enzymes and bilirubin levels to normal.[13] Liver failure is also a rare but possible toxic effect of amoxicillin-clavulanic acid.

Beta-lactamase inhibitors, such as clavulanic acid, are an essential tool for treating bacterial infections capable of producing beta-lactamase. To prevent an increase in antibiotic resistance, it is critical to administer this drug only to patients infected with beta-lactamase-producing bacteria. It is also crucial that pharmacists, nurses, and physicians work together as an interprofessional team to make sure the drug is administered safely and in the appropriate setting to avoid adverse effects or reactions to clavulanic acid and amoxicillin. Clinicians are responsible for initial agent selection, but the pharmacist can weigh in after performing medication reconciliation and verifying dosing. Nursing will often be responsible for administration instructions, confirmed by the pharmacist, and can follow up to assess compliance as well as the effectiveness of the regimen. Any deviations from expected in the above should be reported to the prescribing/ordering clinician. In this manner, the entire interprofessional team can guide and participate in the antimicrobial regimen to optimize patient results. [Level 5]