⚡ Quick Answer — What is Augmentin DDS Syrup?
Augmentin DDS Syrup is a high-strength paediatric amoxicillin + clavulanic acid oral suspension (GSK) for moderate-to-severe paediatric ear, sinus, throat, and respiratory infections, including those requiring high-dose dosing for resistant pneumococcus. Reconstitute and refrigerate after mixing — discard after 7 days.
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How Augmentin DDS Syrup works
Augmentin DDS Syrup combines two molecules: amoxicillin (an aminopenicillin antibiotic that blocks bacterial cell-wall synthesis by binding penicillin-binding proteins) and clavulanic acid (a beta-lactamase inhibitor that protects amoxicillin from enzymatic destruction by resistant bacteria). The combination broadens the antibacterial spectrum to include beta-lactamase-producing Staphylococcus aureus (MSSA), Haemophilus influenzae, Moraxella catarrhalis, Klebsiella, oral anaerobes (Bacteroides) and Bacteroides fragilis. It does NOT cover MRSA, Pseudomonas aeruginosa, ESBL-producing Enterobacteriaceae, Mycoplasma, Chlamydia or Legionella.
Indications & dosing
| Indicatie | Dosering | Duur |
|---|---|---|
| Acute bacterial sinusitis / acute otitis media (high-dose for resistant pneumococcus) | 875 mg/125 mg twice daily — high-dose 2 g/125 mg twice daily for treatment failure | 5–7 days |
| Community-acquired pneumonia (mild–moderate, ambulatory) | 875 mg/125 mg twice daily | 5–7 days |
| Acute exacerbation of COPD with sputum change | 875 mg/125 mg twice daily | 5 days |
| Skin / soft tissue infection — bites, diabetic foot, mild cellulitis | 875 mg/125 mg twice daily | 7–10 days |
| Complicated UTI / pyelonephritis (sensitive) | 875 mg/125 mg twice daily | 7–10 days |
| Dental abscess (with adequate drainage) | 875 mg/125 mg twice daily | 5 days |
| Prophylaxis — open fracture, animal bite | As per surgical / wound protocol | Per protocol |
Renal dose adjustment: Use the lower-strength formulation (500 mg/125 mg) at 12-hourly when CrCl 10–30; 24-hourly when CrCl <10. The 875/125 strength is best avoided in CrCl <30. Haemodialysis — give one dose post-dialysis.
Paediatric: use the dry-syrup formulation. Standard 25–45 mg/kg/day amoxicillin component divided 12-hourly; high-dose (90 mg/kg/day) for AOM in penicillin-resistant pneumococcus. Always dose by amoxicillin component, not total weight of combination.
Bijwerkingen
- Diarrhoea (10–15%) — markedly higher than plain amoxicillin because of the clavulanate component. Usually not C. difficile but watch for it.
- Nausea, vomiting — taking with the start of a meal reduces this.
- Cholestatic hepatitis — distinctive but uncommon (~1 in 6,000 courses); higher risk in older men, prolonged courses, second / repeated exposure. Onset may be delayed up to 6 weeks after the course finishes. Resolves on stopping the drug.
- Rash, urticaria, angioedema — penicillin-class hypersensitivity.
- Vaginal / oral candidiasis with longer courses.
- C. difficile colitis — return for review with new watery diarrhoea, fever, abdominal pain.
Co-amoxiclav has the highest cholestatic-jaundice risk of any commonly used oral antibiotic. Risk rises with: age > 55, male sex, courses > 14 days, and repeated exposure (within 1 year of a previous course). Symptoms — yellow skin or eyes, dark urine, pale stools, generalised itching, right-upper-quadrant pain — can begin DURING the course or up to 6 weeks AFTER stopping. Stop the antibiotic immediately and seek medical review with LFTs.
Contra-indicaties
- Previous co-amoxiclav-induced cholestatic jaundice or hepatic dysfunction (lifelong contraindication).
- IgE-mediated penicillin allergy.
- Severe renal impairment without dose adjustment.
- Glandular fever (high rash incidence).
Geneesmiddelinteracties
| Geneesmiddel | Effect | Actie |
|---|---|---|
| Warfarine | INR may rise — multiple mechanisms | Check INR within 3–5 days; counsel on bleeding signs |
| Methotrexaat | Reduced renal clearance, marrow toxicity risk | Hold methotrexate or check level; specialist input if >25 mg/week |
| Allopurinol | Increased rash incidence | Continue but counsel |
| Probenecide | Raises amoxicillin levels | Geen routinematige aanpassing |
| Mycophenolate | May reduce mycophenolate levels | Monitor for transplant graft markers |
Pregnancy & Breastfeeding
Co-amoxiclav is widely used in pregnancy and considered safe (FDA category B). Some neonatal-medicine groups prefer plain amoxicillin in pregnancy because of a small association between antenatal co-amoxiclav and necrotising enterocolitis in preterm infants when given peripartum — discuss with obstetric team if labour is imminent.
Opslag
Store below 25 °C, away from direct sunlight and moisture. Keep in original packaging. Keep out of reach of children. Discard any unused tablets after the printed expiry date — degraded antibiotics can lose potency or release breakdown products.
Reconstituted dry syrup storage: after mixing with the supplied water, the suspension is stable in a domestic refrigerator (2–8 °C) for 7 days. Discard any unused liquid after this. Shake well before each dose.
This medicine is only effective against bacterial infections. Do not use it for viral illnesses (common cold, most sore throats, flu, COVID-19), do not stop early when you feel better, and do not save leftovers for future infections. Misuse drives drug-resistant bacteria like MRSA, ESBL, and CRE — the WHO ranks antimicrobial resistance among the top 10 global public-health threats.
Veelgestelde vragen
Why does Augmentin DDS Syrup upset my stomach more than plain amoxicillin?
Clavulanic acid increases gut motility and shifts gut flora more aggressively than amoxicillin alone. Take the dose with the start of a meal (food does not reduce absorption) — this dramatically lowers nausea and diarrhoea.
Is Augmentin DDS Syrup the same as Augmentin?
Yes — Augmentin is GSK’s original brand name; co-amoxiclav, Clavam, Moxikind-CV and several other names are bioequivalent generic combinations of amoxicillin and clavulanic acid.
Why is the higher-strength tablet (875/125) only twice daily, not three times?
Clavulanic acid has a short half-life. The 875/125 BD regimen delivers enough amoxicillin AUC for most pathogens while limiting GI side effects from clavulanate. The 500/125 TDS regimen is used when more frequent clavulanate cover is desirable (paediatric, very ill).
Can I take it with my contraceptive pill?
Yes — modern evidence does not support a clinically significant reduction in pill efficacy with co-amoxiclav. Continue your usual schedule but use additional protection if you experience vomiting or diarrhoea (which IS known to reduce absorption).
I had jaundice after a previous course — is it safe to take again?
No. Co-amoxiclav-induced cholestatic hepatitis is a lifelong contraindication. Inform every future prescriber. Use a non-beta-lactam if a true penicillin allergy was not confirmed; if unsure, see an allergy specialist for skin testing.
What antibiotic do I take if I am penicillin-allergic?
For respiratory tract infection: a macrolide (azithromycin / clarithromycin) or doxycycline. For UTI: nitrofurantoin / trimethoprim / fosfomycin. Discuss with a clinician — the right choice depends on infection site and severity.
Should I take a probiotic during the course?
Several studies show Saccharomyces boulardii reduces co-amoxiclav-associated diarrhoea by 30–40%. Take it 2–3 hours apart from the antibiotic dose. Stop if any GI symptoms.
How long do I take it for a sinus infection?
Standard course is 5–7 days for uncomplicated acute bacterial sinusitis. Many sinus infections are viral and need no antibiotic. If symptoms persist beyond 10 days OR are severe (fever > 39 °C, facial pain, purulent discharge), consider co-amoxiclav.
Mag ik alcohol drinken?
There is no direct interaction. Heavy drinking weakens immune response and increases nausea risk — moderate it during the course.
Why was my child prescribed twice the usual dose for ear infection?
“High-dose” amoxicillin (90 mg/kg/day) is recommended in regions with intermediate penicillin-resistant pneumococcus to clear middle-ear pathogen reliably. Co-amoxiclav uses the same logic but adds clavulanate to cover beta-lactamase-producing H. influenzae.
Other Antibiotics & Anti-Infective Medications
- Mox (Amoxicillin) — narrower-spectrum monotherapy
- Cefoprox (Cefpodoxime) — third-generation cephalosporin alternative
- Cetil (Cefuroxime) — second-generation cephalosporin
- Azee (Azithromycin) — penicillin-allergy alternative
- Levomac (Levofloxacin) — respiratory fluoroquinolone
























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