Neonatal Intensive Care Drug Manual

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Administration
IV infusion: over 30 to 40 minutes. [4], Oral: Administer at the start of a feed (to increase absorption and decrease stomach upset); administer, around-the-clock to promote less variation in peak and trough serum levels. Shake suspension well, before measuring the dose. The dose may be mixed with milk. After mixing, administer immediately.
Monitoring	Renal and hepatic function, full blood count if on prolonged therapy.
Contraindications	Hypersensitivity to penicillins, cephalosporins and carbapenems. Previous history of jaundice/hepatic dysfunction associated with the combination or amoxicillin or, clavulanic acid. Severe renal impairment (creatinine clearance less than 30 mL/minute). Note: infants <7 days, very preterm infants and sick infants frequently have a creatinine clearance <30, mL/minute.
Precautions	In moderate renal impairment: increase the dosing interval and maintain adequate fluid intake, especially with IV doses, to reduce the possibility of amoxicillin crystalluria. Hepatic dysfunction: monitor liver function tests. Concurrent use in CMV infection increases risk of rash. Oral suspension - contains aspartame (source of phenylketonuria), therefore use with caution in, patients with phenylketonuria.

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