Augmentin (Amoxicillin / Clavulanate)¶

Overview¶

Preparation¶

Equipment needed¶

• 1 × Augmentin 1.2 g powder vial
• 1 × 20 mL syringe (for reconstitution)
• Water for Injection (WFI) — 20 mL
• Normal saline (0.9% sodium chloride) — at least 10 mL (for dilutions)
• 1 mL syringes × 3 (one for SPT, two for IDT)
• 21 G needle (for vial entry)
• 25 G needles (for drawing up)
• Labels or marker pen

Step 1 — Reconstitute the stock vial¶

1. Draw up 20 mL of Water for Injection (WFI) into a 20 mL syringe.
2. Inject into the Augmentin 1.2 g vial using aseptic technique.
3. Gently swirl until fully dissolved. Do not shake.
4. The resulting stock solution is Amoxicillin 60 mg/mL + Clavulanate 10 mg/mL. It should appear clear to pale yellow. Discard if cloudy or if particles are visible.
5. Write the date, time and your initials on the vial.

Step 2 — Prepare the SPT solution (neat — 60 mg/mL amox)¶

1. Draw up 0.5–1 mL of the reconstituted stock directly into a 1 mL syringe.
2. This is used neat for the skin prick test.
3. Label: "Augmentin SPT — 60/10 mg/mL".

Step 3 — Prepare IDT dilutions¶

Prepare in this order, using a fresh syringe for each step.

1. IDT 20 mg/2 mg per mL (1:5): Use the 1:5 solution prepared in Step 2. Label: "Augmentin IDT 20/2 mg/mL".
2. IDT 2 mg/0.2 mg per mL (1:50): Draw 0.1 mL of the 20/2 solution (from Step 2) into a new 1 mL syringe. Add 0.9 mL NS. Mix. Label: "Augmentin IDT 2/0.2 mg/mL".

Skin prick test (SPT)¶

Interpretation: Wheal ≥3 mm vs negative control = positive.

Intradermal test (IDT)¶

Dilution series¶

Inject: 0.05 mL intradermal. Read at 15–20 minutes.

Challenge (oral)¶

Oral graded dose protocol¶

Preparation: Augmentin Duo 400/57 suspension — shake well before each dose.

Notes¶

• Augmentin contains amoxicillin plus clavulanate — both components should be noted in documentation.
• Observe a minimum of 30–60 minutes after the final dose.
• Have adrenaline drawn up and labelled before commencing.