Peer-reviewed veterinary case report
Side effects and drug levels of amoxicillin-clavulanic acid in cats
By Benson, Kellyi K et al.Ā·Published in Journal of feline medicine and surgeryĀ·2020Ā·Department of Clinical Sciences, United StatesĀ·View original on PubMed ā
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Original publication title: Pilot study of side effects and serum and urine concentrations of amoxicillin-clavulanic acid in azotemic and non-azotemic cats.
- Species:
- cat
Plain-English summary
A survey of cat owners found that cats with chronic kidney disease (CKD) experienced more side effects from the antibiotic amoxicillin-clavulanic acid compared to those without kidney issues. Specifically, 55% of owners with CKD cats reported needing to change their treatment plan due to side effects, while only 12% of owners with healthy cats reported the same. Additionally, the levels of amoxicillin in the urine were significantly lower in cats with CKD, which may explain the increased side effects. It's important for owners of cats with CKD to monitor for any adverse reactions when their pets are prescribed this medication.
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Abstract
OBJECTIVES: The aims of this study were to determine the side effect frequency and serum and urine drug concentrations of amoxicillin-clavulanic acid in cats with and without azotemic chronic kidney disease (azCKD). METHODS: Owners whose cats had been prescribed amoxicillin-clavulanic acid completed a survey regarding the occurrence and type of side effects, and whether treatment was altered as a result. Cats were defined as azCKD (serum creatinine concentration >2.0 mg/dl, urine specific gravity [USG] <1.035 with a clinical diagnosis of chronic kidney disease) and without azCKD (serum creatinine concentration <2.0 mg/dl). Data were assessed with Fisher's exact test. Serum and urine samples were obtained from client-owned cats with azCKD (n = 6) and without azCKD (n = 6, serum creatinine concentration <1.8 mg/dl, USG >1.035) that were receiving amoxicillin-clavulanic acid. Amoxicillin and clavulanic acid were measured with liquid chromatography coupled to tandem mass spectrometry and compared between groups with a Mann-Whitney test. Correlation between serum creatinine and drug concentrations in urine and serum was determined using Spearman's rank test. RESULTS: Sixty-one surveys were returned (11 azCKD cats and 50 without azCKD cats). No significant difference in the presence of side effects or type of side effects was seen between groups; however, significantly more azCKD cats had more than one side effect ( = 0.02). More owners of azCKD cats reported that an alteration in treatment plan was necessitated by side effects (55% vs 12%; = 0.008). Urine amoxicillin was significantly lower in cats with azCKD ( = 0.01) and serum amoxicillin trended toward significance ( = 0.07). Serum amoxicillin concentration was positively correlated with serum creatinine ( = 0.02; = 0.62) and urine amoxicillin concentration was negatively correlated with serum creatinine ( = 0.01; = -0.65). CONCLUSIONS AND RELEVANCE: The data suggest that cats with azCKD have altered pharmacokinetics of amoxicillin, which may contribute to an increased incidence of multiple side effects.
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Search related cases āOriginal publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31660773/