From the Guidelines
For strep throat, Augmentin (amoxicillin-clavulanate) is typically prescribed at a dose of 875 mg/125 mg twice daily for adults or 45 mg/kg/day divided into two doses for children, with a standard treatment duration of 10 days. While penicillin or amoxicillin alone is usually the first-line treatment for strep throat, Augmentin may be used in cases where there's concern about beta-lactamase producing organisms or when a broader spectrum antibiotic is needed 1. It's essential to complete the full 10-day course even if symptoms improve earlier to ensure complete eradication of the bacteria and prevent complications like rheumatic fever.
Some key points to consider when prescribing Augmentin for strep throat include:
- The importance of taking the medication with food to reduce stomach upset
- Being aware of common side effects, which include diarrhea, nausea, and rash
- Contacting a healthcare provider immediately if severe diarrhea, severe rash, or difficulty breathing occur, as these could indicate an allergic reaction or C. difficile infection
- The need to exclude the diagnosis of GAS pharyngitis to prevent inappropriate administration of antimicrobials to large numbers of patients with nonstreptococcal pharyngitis, as antimicrobial therapy is of no proven benefit as treatment for acute pharyngitis due to organisms other than GAS 1.
In terms of the evidence, a study published in the Clinical Infectious Diseases journal in 2012 provides guidance on the diagnosis and management of group A streptococcal pharyngitis, including recommendations for antibiotic regimens 1. According to this study, penicillin or amoxicillin is usually the first-line treatment for strep throat, but Augmentin may be used in certain cases. The study also emphasizes the importance of completing the full 10-day course of antibiotic treatment to prevent complications.
From the FDA Drug Label
It is recommended that there be at least 10 days’ treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever. Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained.
The duration of amoxicillin for strep throat is at least 10 days. The dose for strep throat is:
- For patients weighing less than 40 kg: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours for mild/moderate infections, and 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours for severe infections.
- For patients weighing 40 kg or more: 500 mg every 12 hours or 250 mg every 8 hours for mild/moderate infections, and 875 mg every 12 hours or 500 mg every 8 hours for severe infections 2.
From the Research
Duration and Dose of Augmentin for Strep Throat
- The recommended duration of antibiotic treatment for strep throat is 10 days 3, 4, 5, 6.
- The dose of Augmentin (amoxicillin/clavulanic acid) for strep throat is not explicitly stated in the provided studies, but a study comparing amoxicillin/clavulanic acid with amoxicillin for strep throat used a dose of 875+125 mg twice daily for 10 days 6.
- Another study used a dose of 750 mg or 1000 mg of amoxicillin once daily for 10 days, but this was for amoxicillin only, not Augmentin 5.
- A review of different antibiotic treatments for group A streptococcal pharyngitis found that cephalosporins, macrolides, and carbacephem may be effective alternatives to penicillin, but the evidence is uncertain 7.
Efficacy and Safety of Augmentin for Strep Throat
- A study found that amoxicillin/clavulanic acid had high therapeutic efficacy in the treatment of acute streptococcal tonsillopharyngitis, comparable to amoxicillin, but with a significantly higher safety profile 6.
- Another study found that once-daily amoxicillin was not inferior to twice-daily amoxicillin in the treatment of group A streptococcal pharyngitis 5.
- A review of different antibiotic treatments for group A streptococcal pharyngitis found that the evidence for the efficacy and safety of different antibiotics is uncertain, and more research is needed to determine the best treatment options 7.