From the FDA Drug Label
This drug is known to be substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Amoxicillin is primarily eliminated by the kidney and dosage adjustment is usually required in patients with severe renal impairment (GFR < 30 mL/min). High blood levels may occur more readily in patients with impaired renal function because of decreased renal clearance of amoxicillin and clavulanate potassium
Key Points:
- The drug is substantially excreted by the kidney.
- Patients with impaired renal function are at a greater risk of adverse reactions.
- Dosage adjustment is required in patients with severe renal impairment.
- Renal impairment may lead to high blood levels of the drug due to decreased renal clearance.
The use of Augmentin in patients with UTI and kidney function issues requires caution and dosage adjustment in patients with severe renal impairment 1, 1.
From the Research
Augmentin can be used to treat urinary tract infections (UTIs) in patients with normal kidney function, but requires careful consideration and dose adjustment in those with impaired kidney function, as evidenced by the most recent study 2. When considering the use of Augmentin for UTIs, it is essential to assess the patient's kidney function to determine the appropriate dose.
- For patients with normal kidney function, the typical adult dose is 875mg/125mg twice daily for 5-7 days for uncomplicated UTIs.
- However, dose adjustment is necessary for those with impaired kidney function, with a recommended dose of 500mg/125mg twice daily for moderate impairment (creatinine clearance 10-30 mL/min) and 500mg/125mg once daily for severe impairment (creatinine clearance <10 mL/min). Kidney function should be monitored during treatment as Augmentin can occasionally cause nephritis or worsen existing kidney problems, as noted in a study from 3. Patients should complete the full course of antibiotics even if symptoms improve, drink plenty of water, and report any side effects like severe diarrhea or signs of allergic reaction. The effectiveness of Augmentin in treating UTIs is supported by a recent study 2, which found that amoxicillin-clavulanate may be a useful alternative therapy for the treatment of ceftriaxone non-susceptible Enterobacterales UTIs. Additionally, a study from 4 highlighted the importance of considering prior antibiotic exposure, particularly to fluoroquinolones, when prescribing Augmentin for UTIs. Overall, Augmentin remains a viable option for treating UTIs, but its use should be guided by careful consideration of the patient's kidney function and medical history, as well as the potential risks and benefits, as discussed in a review article 5.