From the Guidelines
Amoxicillin is generally preferred over Augmentin for uncomplicated acute bacterial sinusitis, but Augmentin is recommended for more severe or complicated cases, or when there's concern about beta-lactamase producing bacteria, treatment failure with amoxicillin, or in patients with recent antibiotic use, or underlying conditions. The choice between amoxicillin and Augmentin (amoxicillin-clavulanate) for treating sinusitis depends on the severity of the infection and the presence of certain risk factors. For uncomplicated acute bacterial sinusitis, amoxicillin alone at 500-875 mg three times daily for 5-10 days is typically the first-line treatment, as it is effective against the most common bacterial causes of sinusitis, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 1. However, Augmentin is recommended when there's concern about beta-lactamase producing bacteria, treatment failure with amoxicillin, or in patients with more severe symptoms, recent antibiotic use, or underlying conditions, as the clavulanate component inhibits beta-lactamase enzymes that would otherwise destroy amoxicillin, making it more effective against resistant bacteria 1.
Some key points to consider when choosing between amoxicillin and Augmentin include:
- The severity of the infection: Augmentin is generally preferred for more severe or complicated cases of sinusitis.
- The presence of beta-lactamase producing bacteria: Augmentin is more effective against these bacteria due to the clavulanate component.
- Recent antibiotic use: Augmentin may be preferred in patients who have recently used antibiotics, as it is more effective against resistant bacteria.
- Underlying conditions: Patients with underlying conditions, such as immune system disorders, may require Augmentin due to the increased risk of resistant bacteria.
It's also important to note that both medications can cause side effects, such as diarrhea, nausea, and rash, but Augmentin tends to cause more gastrointestinal issues 1. Patients should complete the full course of either medication even if symptoms improve before finishing treatment.
In terms of specific dosages, the typical Augmentin dosage is 875 mg amoxicillin/125 mg clavulanate twice daily for 5-10 days, while amoxicillin alone is typically given at 500-875 mg three times daily for 5-10 days 1. Ultimately, the choice between amoxicillin and Augmentin should be based on the individual patient's needs and medical history, and should be made in consultation with a healthcare provider.
From the Research
Comparison of Amoxicillin and Augmentin for Sinusitis
- Amoxicillin and Augmentin (amoxicillin-clavulanate) are both commonly used antibiotics for the treatment of acute bacterial sinusitis 2, 3.
- Augmentin is often prescribed for patients who are allergic to penicillin or have not responded to amoxicillin 2.
- Studies have shown that both amoxicillin and Augmentin are effective in treating acute bacterial sinusitis, with similar clinical response rates 4, 5.
- However, Augmentin has been shown to have a broader spectrum of activity against certain bacteria, such as Haemophilus influenzae and Moraxella catarrhalis 3, 4.
Efficacy and Safety
- A study comparing cefdinir and Augmentin found that both antibiotics had similar clinical response rates and microbiologic eradication rates 4.
- Another study comparing levofloxacin and Augmentin found that levofloxacin was as effective as Augmentin, but with fewer adverse events 5.
- The optimal duration of therapy for acute sinusitis is unknown, but studies suggest that a 10- to 14-day treatment course is commonly recommended 2, 6.
- However, some studies suggest that shorter treatment courses (e.g. 5 days) may be effective and offer advantages such as reduced antibiotic resistance and side effects 6.
Treatment Guidelines
- Guidelines for the treatment of acute bacterial sinusitis recommend the use of antibiotics such as amoxicillin or Augmentin, depending on the severity of symptoms and patient factors 2, 3.
- The choice of antibiotic should be based on the suspected causative pathogens and the patient's medical history, including any allergies or previous antibiotic use 3.
- Patients with mild disease may be treated with narrow-spectrum antibiotics such as amoxicillin, while those with more severe disease or recent antibiotic use may require broader-spectrum antibiotics such as Augmentin 3.