From the Guidelines
Amoxiclav 875/125 mg should be administered twice daily (every 12 hours) to provide adequate blood levels of the antibiotic combination and maintain patient convenience and adherence. This dosing regimen is supported by the study by Namyslowski et al. 1 which compared amoxicillin-clavulanate 875/125mg twice daily for 14 days to cefuroxime 500mg twice daily for 14 days in patients with chronic rhinosinusitis (CRS) or acute exacerbation of CRS, and found no significant difference in clinical cure rates or bacteriologic eradication between the two treatment groups. Additionally, the study found significant improvement in symptoms of infection at day 3 to 5 in the amoxicillin-clavulanate group compared to cefuroxime. The twice-daily dosing schedule is also recommended by the Infectious Diseases Society of America 1 for the treatment of skin and soft tissue infections, including those caused by streptococci, S. aureus, and Eikenella corrodens, as well as multiple anaerobic organisms.
Some key points to consider when administering amoxiclav 875/125 mg include:
- Taking the medication with food to reduce gastrointestinal side effects and enhance absorption
- Completing the full course of antibiotics as prescribed, even if symptoms improve before finishing the medication, to prevent antibiotic resistance and ensure complete eradication of the infection
- Monitoring for potential side effects, such as diarrhea, which was the most common adverse event observed in the study by Namyslowski et al. 1
- Considering alternative dosing regimens or medications if the patient has a history of hypersensitivity to β-lactams or other allergies.
It's worth noting that the study by Amini et al. 1 found no statistically significant differences in clinical improvement of symptoms or adverse events between amoxicillin-clavulanate 625 mg three times daily for 3 weeks and clarithromycin 500 mg daily for 3 weeks in patients with CRS, suggesting that the twice-daily dosing schedule of amoxiclav 875/125 mg may be sufficient for treating CRS. However, the study by Jareoncharsri et al. 1 found that levofloxacin 300 mg daily for 14 days and amoxicillin clavulanate 625 mg three times daily for 14 days had comparable clinical response, radiologic improvement, bacteriologic eradication, laboratory tests, vital signs, and adverse events at 14 days in patients with acute maxillary sinusitis or acute exacerbation of CRS.
Overall, the twice-daily dosing schedule of amoxiclav 875/125 mg is a convenient and effective regimen for treating a variety of bacterial infections, including CRS and skin and soft tissue infections.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Amoxiclav Dosage Frequency
The dosage frequency of amoxiclav 875/125 can be given as follows:
- Twice daily: This dosage frequency is supported by several studies, including 2, 3, and 4, which showed that amoxiclav 875/125 given twice daily is as effective as other antibiotic regimens in treating various infections.
- Three times daily: Although there is evidence to suggest that twice daily is sufficient, study 5 compared amoxycillin/clavulanate 875/125 mg twice daily with amoxycillin/clavulanate 500/125 mg three times daily and found no statistically significant difference between treatments.
Key Findings
Some key findings from the studies include:
- Amoxiclav 875/125 given twice daily has high clinical success rates, ranging from 91.2% to 95% in various studies 2, 4, 5.
- The twice daily regimen is well tolerated, with a similar incidence of adverse events compared to other antibiotic regimens 2, 3, 4.
- The three times daily regimen may not provide additional benefits in terms of clinical success rates or bacteriological efficacy 5.