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November 19, 1982

Penicillin gets some help against resistant pathogens

JAMA. 1982;248(19):2427. doi:10.1001/jama.1982.03330190013005

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New approaches to putting the sting back into penicillin drugs to which a variety of pathogens have developed resistance are proving themselves clinically effective, according to several presentations at the Third Mediterranean Congress of Chemotherapy in Dubrovnik, Yugoslavia.

One approach involves mixing an antibiotic—such as amoxicillin—with clavulanic acid, a substance that inhibits the β-lactamase enzymes that pathogenic bacteria use to hydrolyze the drug. Another more recent development combines an antibiotic and an enzyme inhibitor in a single molecule.

Clinical trials carried out in France showed that oral administration of a 4 to 1 mixture of amoxicillin and clavulanic acid (called augmentin) could achieve a high cure rate against previously resistant nosocomial infections of the respiratory tract and urinary tract as well as against pediatric ear and throat infections. Side effects were minimal, and the relapse rate was low.

The amoxicillin-clavulanic acid combination cured respiratory infections in 30 of 34 adult