The amoxicillin-clavulanate combination (Augmentin) frequently induces gastric complaints and diarrhea by an unknown mechanism. The aim of this study was to assess the effects of two orally therapeutic regimens of amoxicillin-clavulanate on small bowel motility in human beings. Duodeno-jejunal manometric recordings were performed in six healthy subjects treated in a cross-over double-blind study with placebo; amoxicillinclavulanate, 1 g plus 250 mg per os every 12 h for 3 days; or amoxicillin-clavulanate, 1 g plus 250 mg per os every 12 h on day 3 only (1-day regimen). Recordings were all performed on day 3 during a diurnal fasting period, a fed state after a standard dinner, and a nocturnal fasting period. Amoxicillin-clavulanate did not affect the motility of the small intestine during the diurnal fast or the fed state. During the nocturnal fast, amoxicillin-clavulanate significantly increased the motility index of the nonpropagated contractions and tended to increase the duration and the amplitude of the propagated contractions. The same digestive motor effect was already observed on the first day of treatment (1-day regimen). This study demonstrates that the oral administration of a therapeutic regimen of amoxicillin-clavulanate is associated, in most cases, with the occurrence of small intestinal motor disturbances.The amoxicillin-clavulanate combination (Augmentin), one of the most widely used antibiotics, frequently induces gastrointestinal side effects, such as nausea, vomiting, cramping (prevalence, 3 to 6%), or diarrhea (prevalence, 4 to 15%) (3, 5). These prevalences are higher than those reported with other orally administrated beta-lactams (10). These effects are usually minor and transient, but they sometimes lead to interruption of the treatment (3). As for other broad-spectrum antibiotics, disturbances of the normal gastrointestinal microfiora are often incriminated, but there is no proof of this. The aim of this study was to test whether the oral administration of a therapeutic regimen of amoxicillin-clavulanate in healthy volunteers is accompanied by changes in small bowel motility, as reported previously for macrolide antibiotics (11).
MATERIALS AND METHODSSubjects. Seven healthy male volunteers (ages, 22 to 28 years) were included in the study. No subject was taking any medication or had a history of gastrointestinal symptoms or surgery. The study was approved by the Ethical Committee of the Medical University of Rouen, and written informed consent was obtained from each subject.Recording system. As reported previously (4, 6), intraluminal pressures were recorded from four side holes cut into an assembly of four polyvinyl tubes (internal diameter, 0.8 mm). The sensors were located at 5, 15, 25, and 35 cm from a rubber stall containing 2 ml of mercury and fixed to the tip of the tube to facilitate positioning. Radiopaque marks were inserted in the catheters near the side holes and at the tip to facilitate the fluoroscopic control of the position to the assembly. The probe was advanced so that ...