Just Ask the Expert: An alternative to Clavamox Drops?

dvm360dvm360 May 2019
Volume 50
Issue 5

Veterinary pharmacology expert Dr. Dawn Boothe addresses the possible pitfall of generics, the finer points of fluoroquinolones and the appropriate application of amoxicillin.

"I hope whatever they're talking about, it's ME." (adobestock.com / Vadim Guzhva)

Editor's note: After receiving this question, we reached out to Zoetis for more information. The company responded that Clavamox Drops are on backorder until the second quarter of 2019 but that Clavamox Chewable tablets are in full supply.

Q: Clavamox Drops (Zoetis) is a frequently used antibiotic for cats but is unavailable for the near future. What can be used in its place? Generic amoxicillin-clavulanate for suspension? Alternatives like fluoroquinolone class antibiotics?

A: There are two possible options. But before we get to those, remember that amoxicillin, with or without clavulanic acid, shouldn't be used to treat gram-negative infections unless they're located in the urinary tract. And as far as I'm concerned, because of its short one-hour half-life, it is a q8h drug (e.g. in the morning, after getting home from work and at bedtime).

For option one, if Staphylococcus species aren't being treated, you may not need the clavulanate, and amoxicillin will work on its own. For option two, the answer is yes-one probably could use generic amoxicillin-clavulanate instead. I say probably because without bioavailability studies in dogs or cats, we can't know for sure that it's absorbed the same way Clavamox is. I wouldn't use the slow-release human Clavamox preparations, however, as they are more likely to be absorbed differently.

I don't consider fluoroquinolone antibiotics to be an amoxicillin-clavulanate substitute for several reasons. I think of the fluoroquinolones as a higher tier class of antimicrobials. If therapy fails, you leave behind a population of high-level multidrug-resistant microbes. Moreover, their gram-negative spectrum is much better than that of amoxicillin and can include Pseudomonas species (depending on the isolate). I thus like to protect them and recommend reserving their use based on culture and susceptibility results when possible.

Dr. Dawn M. Boothe is a professor of physiology and pharmacology at Auburn University College of Veterinary Medicine. She also serves as the director of the Clinical Pharmacology Laboratory, which offers therapeutic drug monitoring services to veterinary practices throughout the country and across the globe.

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