What is the dosage of amoxicillin (Amoxil) and clavulanic acid (Augmentin) for a dog bite?

From the Guidelines

For a dog bite, the recommended antibiotic treatment is amoxicillin-clavulanic acid at a dose of 875 mg amoxicillin/125 mg clavulanic acid taken orally twice daily. This medication should be started as soon as possible after the bite occurs, as it is effective against the polymicrobial nature of dog bite infections, including both aerobic and anaerobic bacteria commonly found in canine oral flora such as Pasteurella, Streptococcus, Staphylococcus, and Fusobacterium species 1. The clavulanic acid component inhibits beta-lactamase enzymes that would otherwise break down amoxicillin, making the combination effective against resistant organisms.

Some key points to consider when treating dog bites include:

• The decision to give “prophylactic” antibiotics should be based on wound severity and host immune competence 1
• Prophylactic or early preemptive therapy seems to provide marginal benefit to wound care for patients with dog bites who present within 12–24 hours after injury, particularly in low-risk wounds 1
• Amoxicillin-clavulanate administered in one study for a variety of full-skin thickness animal bites in patients presenting >9 hours after the bite resulted in a lower infection rate 1

For patients with penicillin allergies, alternatives include doxycycline, trimethoprim-sulfamethoxazole plus clindamycin, or a fluoroquinolone plus clindamycin. In addition to antibiotics, proper wound care including thorough cleaning, debridement if necessary, and tetanus prophylaxis should be administered. Patients should monitor for signs of infection such as increasing pain, redness, swelling, or drainage from the wound site.

It's worth noting that the evidence for antibiotic treatment in dog bites is based on studies with variable quality and diverse approaches to wound care, and the decision to treat should be individualized based on the specific patient and wound characteristics 1. However, amoxicillin-clavulanic acid remains the recommended first-line treatment for dog bites due to its broad coverage and effectiveness against common canine oral flora 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION ... For more severe infections and infections of the respiratory tract, the dose should be one amoxicillin and clavulanate potassium tablet USP, 875 mg/125 mg every 12 hours or one amoxicillin and clavulanate potassium tablet USP, 500 mg/125 mg every 8 hours.

The recommended dose of amoxicillin and clavulanic acid for a dog bite is not explicitly stated in the label. However, for severe infections, the dose is 875 mg/125 mg every 12 hours or 500 mg/125 mg every 8 hours 2.

• Amoxicillin dose: 875 mg or 500 mg
• Clavulanic acid dose: 125 mg Since dog bites can be considered severe infections, these doses may be applicable.

From the Research

Dosage of Amoxicillin and Clavulanic Acid for Dog Bites

• The dosage of amoxicillin and clavulanic acid for dog bites is not explicitly stated in the provided studies, but the studies suggest that amoxicillin-clavulanic acid is an effective empirical antimicrobial choice for moderate dog bite wounds 3, 4.
• A study published in 1997 found that dosing of amoxicillin/clavulanate given every 12 hours is as effective as dosing every 8 hours for treatment of lower respiratory tract infection, with a dosage of 875/125 mg every 12 hours or 500/125 mg every 8 hours 5.
• Another study published in 2020 discussed the properties, indications, and usage of oral amoxicillin and amoxicillin-clavulanic acid, but did not provide specific dosage recommendations for dog bites 6.
• The studies suggest that the choice of dosage and administration frequency may depend on various factors, including the severity of the wound, the presence of other health conditions, and the risk of antibiotic resistance 3, 4, 7.

Administration Frequency and Dosage

• The administration frequency and dosage of amoxicillin and clavulanic acid may vary depending on the specific circumstances of the dog bite, but the studies suggest that a dosage of 875/125 mg every 12 hours or 500/125 mg every 8 hours may be effective 5.
• A study published in 2021 found that amoxicillin-clavulanic acid was prescribed in 73.4% of dogs with dog bite wounds, but the study did not provide information on the specific dosage or administration frequency used 4.
• Another study published in 2010 found that prophylactic antibiotics were cost-effective if the risk of wound infection was greater than 5% and antibiotics could decrease that risk by greater than 3%, but the study did not provide specific dosage recommendations for amoxicillin and clavulanic acid 7.