From the Guidelines
Augmentin (amoxicillin/clavulanic acid) can be used to treat urinary tract infections (UTIs), but it is not the first-line treatment due to its relatively poor efficacy and higher propensity for adverse effects compared to other UTI antimicrobials. According to the most recent and highest quality study 1, the recommended first-line treatments for uncomplicated UTIs are nitrofurantoin, trimethoprim-sulfamethoxazole, or fosfomycin. However, Augmentin may be considered as an alternative treatment when other recommended agents cannot be used, as stated in the 2011 guidelines 1.
The dosage and duration of Augmentin treatment for UTIs may vary depending on the severity of the infection, but it is commonly prescribed at doses of 500/125 mg or 875/125 mg taken twice daily for 3-7 days. It's essential to complete the entire prescribed course, even if symptoms improve, and to drink plenty of water to help flush the urinary system. Common side effects may include diarrhea, nausea, and yeast infections, and patients should contact their healthcare provider if they experience severe diarrhea, rash, or no improvement in symptoms after 48 hours.
Some key points to consider when treating UTIs with Augmentin include:
- The IDSA/European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guideline recommends treatment durations depending on the type of antibiotic, including 5 days of nitrofurantoin, 3 days of trimethoprim-sulfamethoxazole, or a single dose of fosfomycin 1.
- Fluoroquinolones are highly efficacious in 3-day regimens but have a high propensity for adverse effects and should be reserved for patients with a history of resistant organisms 1.
- The AUA systematic review highlights the importance of considering resistance prevalence and collateral damage when choosing UTI treatments 1.
Overall, while Augmentin can be used to treat UTIs, it is essential to consider the potential risks and benefits and to choose the most appropriate treatment based on the individual patient's needs and the local antibiogram.
From the FDA Drug Label
Amoxicillin/clavulanic acid has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections as described in INDICATIONS AND USAGE Gram-Negative Aerobes: Enterobacter species (Although most strains of Enterobacter species are resistant in vitro, clinical efficacy has been demonstrated with Amoxicillin and Clavulanate Potassium in urinary tract infections caused by these organisms.) Escherichia coli (β-lactamase and non−β-lactamase−producing) Haemophilus influenzae (β-lactamase and non−β-lactamase−producing) Klebsiella species (All known strains are β-lactamase−producing.) Moraxella catarrhalis (β-lactamase and non−β-lactamase−producing)
Yes, Augmentin (amoxicillin/clavulanic acid) can treat a urinary tract infection (UTI) caused by certain microorganisms, including:
- Enterobacter species
- Escherichia coli
- Klebsiella species 2
From the Research
Effectiveness of Augmentin in Treating UTIs
- Augmentin (amoxicillin/clavulanic acid) has been compared to other antibiotics in the treatment of urinary tract infections (UTIs) in several studies 3, 4, 5, 6.
- A study published in 1983 found that Augmentin was less effective than co-trimoxazole in treating uncomplicated UTIs, with a cure rate of 83% compared to 100% for co-trimoxazole 3.
- However, another study published in 1982 found that Augmentin was effective in treating UTIs, particularly those caused by amoxycillin-resistant organisms, with a success rate of about 70% 4.
- A study published in 1990 found that amoxicillin/clavulanic acid (A/Cl) was more effective than trimethoprim (TMP) in treating non-complicated lower UTIs, with a cure rate of 92.8% compared to 58.8% for TMP 5.
- Another study published in 1986 found that Augmentin was more effective than amoxycillin alone in treating UTIs in the elderly, with a response rate of 87.5% compared to 43% for amoxycillin 6.
Side Effects and Resistance
- Augmentin has been associated with side effects such as severe diarrhea, abdominal pain, and light-headedness 3.
- Resistance to Augmentin has been reported, with some studies finding that certain pathogens are resistant to the antibiotic 3, 4.
- However, Augmentin has been found to be effective against amoxycillin-resistant organisms, making it a useful option for treating UTIs caused by these bacteria 4, 6.
Comparison to Other Antibiotics
- Augmentin has been compared to other antibiotics such as co-trimoxazole, trimethoprim, and amoxycillin in the treatment of UTIs 3, 4, 5, 6.
- While some studies have found Augmentin to be less effective than other antibiotics, others have found it to be a useful option for treating UTIs, particularly those caused by amoxycillin-resistant organisms 3, 4, 5, 6.