From the Guidelines
The management plan for a patient with tonsillitis taking Augmentin (amoxicillin/clavulanate) should focus on completing the full antibiotic course while providing supportive care, with a typical duration of 10 days as recommended by the 2012 IDSA clinical guidelines 1. The dosage of Augmentin is typically 875/125 mg twice daily or 500/125 mg three times daily for adults, and for children, the dosage is based on weight, usually 40 mg amoxicillin/kg/d in 3 doses (max = 2000 mg amoxicillin/d) as listed in Table 5 of the 2012 IDSA clinical guidelines 1. Patients should take the medication with food to minimize gastrointestinal side effects and complete the entire prescribed course even if symptoms improve before finishing. Supportive measures include:
- Adequate hydration
- Rest
- Over-the-counter pain relievers like acetaminophen or ibuprofen for pain and fever
- Warm salt water gargles (1/2 teaspoon salt in 8 oz warm water) several times daily
- Soft, cool foods that are easy to swallow Patients should contact their healthcare provider if symptoms worsen after 48-72 hours of treatment, if they develop severe side effects like rash or diarrhea, or if they have difficulty breathing or swallowing. Augmentin is effective for tonsillitis because it combines amoxicillin with clavulanic acid, which helps overcome bacterial resistance by inhibiting beta-lactamase enzymes that would otherwise break down the antibiotic. It is also important to note that antibiotics may prevent complications from group A streptococcal infection, including acute rheumatic fever, peritonsillar abscess, and further spread of group A Streptococcus in outbreaks, as suggested by the American College of Physicians and the Centers for Disease Control and Prevention 2, 3, 4, 5, 6.
From the FDA Drug Label
Patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may: (1) decrease the effectiveness of the immediate treatment, and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by amoxicillin and clavulanate potassium tablets or other antibacterial drugs in the future
The management plan for a patient with tonsillitis taking Augmentin (amoxicillin/clavulanate) is to complete the full course of therapy as directed by the doctor. Patients should be advised to:
- Take the medication exactly as directed
- Not skip doses
- Finish the full course of treatment, even if symptoms improve before completion This is to ensure the effectiveness of the treatment and prevent the development of antibiotic resistance 7.
From the Research
Management Plan for Tonsillitis
- The management plan for a patient with tonsillitis taking Augmentin (amoxicillin/clavulanate) involves a combination of antibiotic treatment and supportive care 8, 9.
- The diagnosis of tonsillitis should include a classification with a scoring system (Centor, McIssac, FeverPAIN score) to estimate the probability of a bacterial tonsillitis, mainly due to group A streptococcus (GAS) 10, 11.
- In cases of high probability of bacterial tonsillitis, standard antibiotic treatment is initiated directly or by delayed prescription 10, 11.
- Augmentin (amoxicillin/clavulanate) is an effective antibiotic for the treatment of acute episodes of recurrent tonsillitis and prevention of recurrent infection 8.
- The course of antibiotic treatment for streptococcal tonsillitis is typically 10 days, which reduces the risk of recurrent episode 11, 9.
Treatment Outcomes
- Studies have shown that amoxicillin/clavulanate is effective in eradicating group A beta-haemolytic streptococci and reducing the risk of recurrent tonsillitis 8, 12.
- Dispersible forms of amoxicillin/clavulanate have been shown to have a higher safety profile and better pharmacokinetic parameters compared to film-coated tablets 9.
- The use of topical drugs, such as benzalkonium chloride + tyrothricin + benzocaine, can be effective in relieving sore throat and shortening the duration of the disease 11.
Patient Monitoring
- Patients with tonsillitis should be monitored for symptoms such as sore throat, difficulty swallowing, and fever 9.
- The clinical global impression of therapy and adherence to treatment should also be assessed 9.
- Patients should be followed up after completion of treatment to assess for resolution of symptoms and prevention of recurrent episodes 8, 12.