Clavulanate Use in Patients with Renal Impairment

Risk Factors and Contraindications

Concomitant use of other nephrotoxic drugs should be avoided or approached with caution in patients with renal impairment 1
Patients with both renal impairment and hepatic disease may be at higher risk for adverse effects and should be monitored more closely, as recommended by the Centers for Disease Control and Prevention 2
The American College of Physicians suggests that NSAIDs should be avoided in combination with clavulanate in patients with renal impairment as they can further impair renal function, although this specific guideline is from a less preferred source, a more relevant source is needed 3

For patients on hemodialysis, the American Thoracic Society recommends administration of clavulanate after dialysis to facilitate direct observation therapy and avoid premature removal of the drug 4