Co-amoxiclav Injectable: Dosing and Precautions
Injectable co-amoxiclav guidance for cellulitis, necrotizing infections, and severe postpartum upper genital tract infection.
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Source reviewed
November 2024
Guide category
Injectable drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Penicillin antibacterial, combined with a beta-lactamase inhibitor. The addition of clavulanic acid to amoxicillin extends its spectrum of activity to cover beta-lactamase producing Gram-positive and Gram-negative organisms, including some Gram-negative anaerobes.
Indications
- Erysipelas and cellulitis.
- Necrotizing infections of the skin and soft tissues, in combination with clindamycin.
- Severe postpartum upper genital tract infection, in combination with gentamicin.
Forms and strengths, route of administration
- Powder for injection, in 1 g amoxicillin/200 mg clavulanic acid vial.
- Dissolve in 20 ml water for injection or 0.9% sodium chloride for slow IV injection over 3 minutes or IV infusion over 30 minutes.
- Do not dilute in glucose.
Dose (expressed in amoxicillin)
Erysipelas, cellulitis
- Child under 3 months: 30 mg/kg every 12 hours.
- Child 3 months and over: 20 to 30 mg/kg every 8 hours, maximum 3 g daily.
- Adult: 1 g every 8 hours.
Necrotizing infections
- Child under 3 months: 50 mg/kg every 12 hours.
- Child 3 months and over and under 40 kg: 50 mg/kg every 8 hours, maximum 6 g daily.
- Child 40 kg and over and adult: 2 g every 8 hours.
Upper genital tract infection
For administration by IV infusion, dilute each dose in 5 ml/kg of 0.9% sodium chloride in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride in children 20 kg and over and in adults.
- Adult: 1 g every 8 hours.
Duration
Change to oral treatment as soon as possible.
- Erysipelas, cellulitis: 7 to 10 days.
- Necrotizing infections: 14 days.
- Upper genital tract infection: depending on clinical response.
Contra-indications, adverse effects, precautions
- Once reconstituted, the solution must be used immediately; discard any unused open vial.
- Do not administer to penicillin-allergic patients, patients with history of hepatic disorders during previous treatment with co-amoxiclav, or patients with infectious mononucleosis.
- Administer with caution to patients allergic to cephalosporins, and to patients with hepatic impairment or severe renal impairment.
- May cause diarrhoea, hepatic disorders, and allergic reactions sometimes severe.
- Do not combine with methotrexate.
- Pregnancy: no contra-indication.
- Breast-feeding: no contra-indication.
- Do not mix with other drugs in the same syringe or infusion bag.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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