title: Early bactericidal activity of amoxicillin in combination with clavulanic acid in patients with sputum smear-positive pulmonary tuberculosis.
abstract: The early bactericidal activity (EBA) of an antituberculosis agent is the rate of decrease in viable colony-forming units (CFU) per milliliter of sputum during the first 2 d of treatment of patients with previously untreated smear-positive pulmonary tuberculosis. The objective of this open randomized study was to evaluate the EBA of the combination of amoxicillin 3 g and clavulanic acid 750 mg. Ten patients with a mean age of 34 y and a mean weight of 56 kg received amoxicillin/clavulanic acid and 5 patients with a mean age of 34 y and a mean weight of 57 kg received no drug. In the patients receiving 1 dose of amoxicillin/clavulanic acid daily for 2 d the mean log10CFU/ml of sputum before treatment was 6.7402 (SD 0.539) and after 2 d of treatment 6.7046 (SD 0.609); the corresponding values in patients receiving no drug were 6.7823 (SD 0.563) and 6.7502 (SD 0.673), respectively. The EBA of 0.018 (SD 0.130) in patients receiving amoxicillin/clavulanic acid did not differ significantly from that of 0.016 (SD 0.069) in patients receiving no drug. It is unlikely that the combination of amoxicillin/clavulanic acid has an important place in the treatment of tuberculosis with the exception of those patients with multidrug-resistant tuberculosis who are otherwise therapeutically destitute.
authors.affiliation: Department of Paediatrics and Child Health, Faculty of Medicine of the University of Stellenbosch, Tygerberg, South Africa.
authors.forename: P R
authors.initials: PR
authors.lastname: Donald
authors.forename: F A
authors.initials: FA
authors.lastname: Sirgel
authors.forename: A
authors.initials: A
authors.lastname: Venter
authors.forename: D P
authors.initials: DP
authors.lastname: Parkin
authors.forename: B W
authors.initials: BW
authors.lastname: Van de Wal
authors.forename: A
authors.initials: A
authors.lastname: Barendse
authors.forename: E
authors.initials: E
authors.lastname: Smit
authors.forename: D
authors.initials: D
authors.lastname: Carman
authors.forename: J
authors.initials: J
authors.lastname: Talent
authors.forename: J
authors.initials: J
authors.lastname: Maritz
mesh_terms: D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001770:Blood Bactericidal Activity / Q000187:drug effects; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013183:Sputum / Q000187:drug effects / Q000382:microbiology*; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination