From the Research
For patients with end-stage renal disease (ESRD), Augmentin (amoxicillin-clavulanate) dosing should be adjusted based on creatinine clearance, with a recommended dose of 250-500 mg every 24 hours for patients on hemodialysis or peritoneal dialysis, as supported by the most recent evidence 1. The adjustment of Augmentin dosing in ESRD patients is crucial to prevent accumulation and potential toxicity, as both amoxicillin and clavulanic acid are eliminated primarily through the kidneys.
- The exact dose depends on the severity of infection being treated, with higher doses used for more severe infections.
- Monitoring for signs of adverse effects such as nausea, vomiting, diarrhea, and rash is important, as these patients may be more susceptible to side effects due to altered drug clearance.
- The extended dosing interval allows for the slower clearance of the medication in ESRD patients, reducing the risk of adverse effects. Key considerations in managing ESRD patients include:
- Close collaboration among primary care physicians, nephrology subspecialists, and other subspecialists to optimize disease management 2, 3.
- Recognition and management of common issues in patients receiving dialysis or after kidney transplantation, such as volume control, blood pressure management, and metabolic complications 4.
- Palliative care and hospice referral for patients who opt for supportive care or discontinue dialysis 5.