Expert Perspectives on the Usage of Co-amoxiclav and Cefuroxime in Clinical Practice: A Cross-Sectional Survey from Indian Settings

Background: Although there are several clinical studies available regarding the management of bacterial infections, there is a dearth of studies among clinical experts on their practice. The survey aimed to assess clinical preferences and decision-making factors among clinicians regarding the use of co-amoxiclav and cefuroxime across a range of common infections and surgical indications in routine clinical practice in Indian settings. Methodology: This cross-sectional study was conducted among clinicians across India using a 22-item structured questionnaire. The questionnaire assessed common infection types, antibiotic usage patterns, indications for co-amoxiclav and cefuroxime, preferred regimens for community-acquired pneumonia (CAP), skin and soft tissue infections, and surgical prophylaxis, perceived comparative efficacy, factors influencing antibiotic choice, adverse drug reactions, and clinical outcomes using a global improvement scale. The data were analyzed using descriptive statistics. Results: Approximately 49% of clinicians identified streptococcal pharyngitis as the most common indication for recommending co-amoxiclav in routine practice. Nearly 60% reported co-amoxiclav as the most preferred empiric antimicrobial therapy for adult CAP in patients without comorbidities, while about 51% preferred it in patients with comorbidities. Around 76% of clinicians favored co-amoxiclav, with or without clindamycin, for the management of mild to moderate cellulitis in diabetic patients. Approximately 41% reported cefuroxime as the preferred prophylactic antibiotic for minimal access or laparoscopic surgeries, and about 37% highlighted long-duration sequential prophylaxis as its key advantage. Nearly 43% of respondents considered co-amoxiclav and cefuroxime to be equally effective for respiratory tract infections. About 66% of clinicians identified bacterial susceptibility as the most important factor influencing the choice between co-amoxiclav and cefuroxime. Conclusion: Co-amoxiclav is the preferred empiric antibiotic for streptococcal pharyngitis, CAP, and diabetic cellulitis, while cefuroxime remains the agent of choice for surgical prophylaxis in laparoscopic procedures. Bacterial susceptibility is the primary factor guiding antibiotic selection. The favorable safety profile and positive patient outcomes associated with co-amoxiclav support its continued role as a cornerstone agent in the empiric management of community-acquired infections in routine clinical practice.