From the Guidelines
Augmentin should be prescribed for a duration of 5 days for uncomplicated cellulitis, with the option to extend treatment if the infection has not improved within this time period. This recommendation is based on the most recent and highest quality study, which suggests that a 5- to 6-day course of antibiotics active against streptococci is sufficient for patients with nonpurulent cellulitis 1. The usual adult dose of Augmentin is 875mg/125mg twice daily or 500mg/125mg three times daily. It's essential to complete the entire prescribed course even if symptoms improve before finishing the medication. During treatment, patients should elevate the affected area when possible, monitor for improvement within 48-72 hours, and watch for side effects like diarrhea, nausea, or rash. If symptoms worsen or don't improve after 2-3 days, medical reassessment is necessary as this could indicate antibiotic resistance or a need for intravenous therapy.
Some key points to consider when prescribing Augmentin for cellulitis include:
- The infection type and severity, as well as the patient's overall health and potential for complications 1
- The importance of monitoring for improvement and potential side effects, and adjusting treatment as needed 1
- The need for patients to self-monitor and have close follow-up with primary care, particularly for those with nonpurulent cellulitis 1
In terms of specific treatment guidelines, the 2014 IDSA guideline recommends that patients should receive antibiotics for uncomplicated cellulitis, but that clinicians should consider extending treatment if the infection has not improved after 5 days 1. The more recent 2019 National Institute for Health and Care Excellence (NICE) guideline recommends a course of 5 to 7 days 1. However, the most recent and highest quality study suggests that a 5- to 6-day course of antibiotics is sufficient for patients with nonpurulent cellulitis 1.
From the Research
Augmentin Duration for Cellulitis
- The optimal duration of Augmentin (amoxicillin-clavulanate) treatment for cellulitis is not clearly established, but studies suggest that the total duration of therapy can be approximately 2 weeks 2.
- A combination therapeutic regimen of amoxicillin + clavulanic acid was linked with the shortest duration of stay in the hospital for patients with erysipelas or bacterial cellulitis 3.
- The mean time to clinical response for uncomplicated cellulitis was 1.68 days, with a 50% reduction of pain and severity score by day 5, and a 30-50% reduction of proportion of patients with edema by day 2-4 4.
- There is no evidence to support the superiority of any one antibiotic over another, including Augmentin, for the treatment of cellulitis, and the use of intravenous antibiotics over oral antibiotics and treatment duration of longer than 5 days were not supported by evidence 5.
- The choice of antibiotic and duration of therapy should be based on the severity of the infection, the presence of comorbidities, and the clinical response to treatment, rather than a fixed duration 2, 6, 3, 4, 5.
Factors Affecting Treatment Duration
- The presence of comorbidities, such as chronic venous insufficiency of the lower limbs and anemia, can affect the duration of treatment for cellulitis 3.
- The severity of the infection, as measured by the presence of chills, redness, and swelling, can also impact the duration of treatment 3, 4.
- The clinical response to treatment, including the reduction of pain, severity score, and edema, should be used to guide the duration of therapy 4.
Antibiotic Treatment Options
- Augmentin (amoxicillin-clavulanate) is one of several antibiotic treatment options for cellulitis, including penicillin, cephalexin, and ceftriaxone 2, 6, 3.
- The choice of antibiotic should be based on the suspected or confirmed causative pathogen, as well as the patient's medical history and allergy status 2, 6.