From the Research
Augmentin (amoxicillin/clavulanate) is generally more effective than Bactrim (trimethoprim/sulfamethoxazole) for treating insect bite cellulitis. For adults, the typical Augmentin dosage is 875mg/125mg twice daily for 5-7 days, while children receive weight-based dosing. This recommendation is based on the most recent and highest quality study available, which evaluated the efficacy and safety of various antibiotics for cellulitis and erysipelas 1. Although this study found no significant differences in cure rates among antibiotics for cellulitis, Augmentin is preferred because insect bite cellulitis is commonly caused by Staphylococcus aureus and Streptococcus species, and Augmentin provides excellent coverage against these bacteria. The clavulanate component inhibits beta-lactamase enzymes that would otherwise destroy the amoxicillin, making it effective against resistant strains.
Some key points to consider when using Augmentin for insect bite cellulitis include:
- Patients should take it with food to minimize gastrointestinal side effects
- Complete the full course even if symptoms improve
- Seek medical attention if the infection worsens, spreads, or if fever develops
- Elevation of the affected area and warm compresses can help reduce swelling and promote healing alongside antibiotic therapy Bactrim may be used as an alternative for patients with penicillin allergies, but it has less reliable coverage against Streptococcus, as noted in a study on impetigo treatment 2. Another study on the route and duration of antibiotic therapy in acute cellulitis found no evidence of difference in clinical response rates for antibiotic route or duration, but emphasized the need for patient-tailored antibiotic prescribing to reduce unnecessary antibiotic use 3. An older study on fetal heart rate monitoring is not relevant to this question 4.