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Amoxicillin clavulanate is a broad spectrum antibiotic that should be reserved for specific indications. The only first-line indications for amoxicillin clavulanate are bites (mammalian–including human), diabetic foot ulcers and mastitis in males and non-lactating females.1

This report uses data from the pharmaceutical collection to provide an update on the use of amoxicillin clavulanate between April, 2014 and March, 2015

Amoxicillin vs amoxicillin clavulanate

Clavulanate possesses little antibacterial activity, but significantly extends the spectrum of activity of amoxicillin when given with it, leading to increased antimicrobial resistance. Amoxicillin clavulanate can also cause diarrhoea and hepatotoxicity, which occur more frequently than with amoxicillin alone.2 The national data shows that in 2014/15 amoxicillin clavulanate accounted for 37% of all penicillin prescribing.

Sample Practice

All antibiotics vs penicillins

701 patients registered to your practice were dispensed a penicillin between April 2014 and March 2015

This accounts for 64% of the 1096 registered patients who were dispensed any antibiotic. Nationally, 72% of all patients dispensed any antibiotic received a penicillin

Penicillins vs amoxicillin clavulanate

20% of the 701 registered patients who were dispensed a penicillin received amoxicillin clavulanate (141 patients)

High use of amoxicillin clavulanate by older patients

Table 1 below shows amoxicillin clavulanate dispensing as a proportion of total penicillin dispensing by age for your practice, ten practices with a patient population similar to yours and nationally.

Nationally the use of amoxicillin clavulanate is higher in those aged 50 years and older (43% of all penicillin prescribing) – with limited indications it is reasonable to suggest that this use is too high.

Table 1. Amoxicillin clavulanate dispensing by age

Sample Practice

% of registered patients (in each age band) who were dispensed a penicillin and received amoxicillin clavulanate Your practice %
(number of patients)
Similar Practices %*
(a comparator)
National %
<5 years 9 (7) 27 29
5–9 years 18 (8) 29 30
10–49 years 24 (70) 36 36
50–74 years 20 (42) 44 43
75+ years 25 (14) 43 42

In the vast majority of cases a narrow spectrum antibiotic such as amoxicillin should be first-line. Undertaking an audit using your practice management software to identify why amoxicillin clavulanate has been prescribed (i.e. indications) may help determine the appropriateness of prescribing in your practice –

  1. bpacnz. Antibiotics, choices for common infections, 2013. Available from: (Accessed Sep, 2015).
  2. eTG complete. Melbourne: Therapeutic Guidelines Limited; 2015 (Accessed Sep, 2015).