Is Augmentin (amoxicillin-clavulanate) effective for treating strep throat?

From the Guidelines

Augmentin (amoxicillin-clavulanate) is not the first-line treatment for strep throat, but it can be effective in certain cases, such as suspected concurrent beta-lactamase-producing bacteria, treatment failure with first-line antibiotics, or recurrent infections. The standard first-line treatment for strep throat (Group A Streptococcal pharyngitis) is penicillin V or amoxicillin alone, as recommended by the Infectious Diseases Society of America 1. According to the guidelines, penicillin V and amoxicillin are effective and safe, with a narrow spectrum and low cost.

Some key points to consider:

• Augmentin contains amoxicillin plus clavulanic acid, which broadens its spectrum of activity against bacteria that produce beta-lactamase enzymes.
• For uncomplicated strep throat, the broader coverage of Augmentin is usually unnecessary since Group A Streptococcus remains highly sensitive to penicillin and amoxicillin.
• When prescribed, a typical adult dose of Augmentin is 875/125 mg twice daily or 500/125 mg three times daily for 10 days.
• Patients should complete the full course of antibiotics even if symptoms improve before finishing the prescription.
• Common side effects of Augmentin include diarrhea, nausea, and rash, and taking it with food can help reduce gastrointestinal side effects.
• Those with penicillin allergies should not take Augmentin and should inform their healthcare provider to receive an alternative treatment, as recommended by the American Heart Association 1.

It's also important to note that the diagnosis of strep throat should be confirmed by a rapid antigen detection test (RADT) or throat culture before initiating treatment, as recommended by the Infectious Diseases Society of America 1. Additionally, the treatment of strep throat should be guided by the severity of symptoms, the presence of complications, and the patient's medical history, as outlined in the guidelines by the American Heart Association 1 and the Infectious Diseases Society of America 1.

From the FDA Drug Label

Amoxicillin for oral suspension is indicated in the treatment of infections due to susceptible (ONLY β-lactamase–negative) isolates of Streptococcusspecies. (α-and β-hemolytic isolates only),

• Strep throat is typically caused by Streptococcus pyogenes, which is a β-hemolytic streptococcal species.
• The provided drug label indicates that amoxicillin is effective against β-hemolytic isolates of Streptococcusspecies, but it does not explicitly mention Augmentin (amoxicillin-clavulanate).
• However, since Augmentin contains amoxicillin, it is likely that Augmentin would offer good coverage for strep throat, but only if the isolate is β-lactamase–negative.
• It is essential to note that the effectiveness of Augmentin against strep throat depends on the susceptibility of the specific Streptococcus isolate.
• The FDA label does provide information on amoxicillin, which is a component of Augmentin, and its effectiveness against Streptococcusspecies 2.

From the Research

Effectiveness of Augmentin for Strep Throat

• Augmentin (amoxicillin-clavulanate) is a broad-spectrum antibiotic that has been used to treat various bacterial infections, including community-acquired respiratory tract infections 3.
• However, for strep throat, which is caused by Group A beta-hemolytic streptococcal pharyngitis, the recommended first-line antibiotics are penicillin and amoxicillin, with a recommended course of 10 days 4, 5.
• There is no direct evidence to suggest that Augmentin is the preferred treatment for strep throat, and its use may not be necessary due to its broad-spectrum activity and potential for contributing to antibiotic resistance 6.
• In fact, guidelines recommend using narrow-spectrum antibiotics, such as penicillin or amoxicillin, to treat strep throat, unless the patient has a non-anaphylactic allergy to penicillin, in which case first-generation cephalosporins may be used 4, 5.

Considerations for Antibiotic Treatment

• The diagnosis of strep throat should be confirmed using clinical decision rules, rapid antigen testing, or throat culture before prescribing antibiotics 4, 5, 6.
• Antibiotic treatment should be tailored to the individual patient's needs, taking into account factors such as allergy history, symptom severity, and potential for antibiotic resistance 6, 7.
• Short-course antibiotic treatment may be effective for some patients with strep throat, but long-course penicillin V remains the recommended first-line treatment due to its narrow spectrum of activity and lower risk of contributing to antibiotic resistance 7.