Augmentin 875 mg Dosing for Adult Infections
For adults with community-acquired infections, Augmentin 875/125 mg should be dosed twice daily (every 12 hours) for most indications, with treatment duration typically 7-14 days depending on the specific infection.
Standard Adult Dosing
The FDA-approved dosing for Augmentin 875/125 mg is one tablet twice daily 1. This formulation delivers 875 mg amoxicillin with 125 mg clavulanate per dose and should be taken at the start of meals to minimize gastrointestinal intolerance and enhance clavulanate absorption 1.
Specific Infection Indications
Acute Bacterial Sinusitis
- Dose: 875/125 mg twice daily for 14 days 2
- Clinical success rates of 93% have been demonstrated with this regimen 2
- The twice-daily dosing is as effective as the older three-times-daily 500/125 mg formulation 2
Community-Acquired Pneumonia (Outpatient)
For adults with comorbidities (chronic heart/lung/liver/renal disease, diabetes, alcoholism, malignancy, or asplenia):
- Dose: 875/125 mg twice daily for 7-10 days 3
- Should be combined with a macrolide (azithromycin or clarithromycin) for optimal coverage 3
- Alternative: Use as monotherapy only if no atypical pathogen coverage needed
For hospitalized pneumonia with aspiration risk or pulmonary abscess:
- Dose: IV amoxicillin-clavulanate 2 g every 6 hours 4
Lower Respiratory Tract Infections/Acute Exacerbations of Chronic Bronchitis
- Dose: 875/125 mg twice daily for 7 days minimum 5
- Clinical success rates of 93-94% demonstrated 5
- The 12-hour dosing interval is equally effective as 8-hour dosing with potentially less diarrhea 5
Skin and Soft Tissue Infections (MSSA)
- Dose: 875/125 mg twice daily 6
- Duration depends on infection severity and clinical response
- For impetigo: typically 7 days 6
Chronic Rhinosinusitis
- Dose: 875/125 mg twice daily for 3 weeks 7
- Studies show comparable efficacy to other broad-spectrum agents 7
Important Clinical Considerations
Dosing Frequency Evidence
Multiple high-quality studies confirm that twice-daily dosing (875/125 mg) is as effective as three-times-daily dosing (500/125 mg) for respiratory tract infections 5, 2. The 12-hour regimen offers:
- Equivalent clinical success rates (93-94%)
- Similar bacteriological eradication
- Potentially reduced moderate-to-severe diarrhea
- Better compliance due to less frequent dosing
When NOT to Use Standard Dosing
Renal impairment: Dose adjustment required - not specified in provided evidence but critical consideration 1
Hepatic impairment: Dose with caution and monitor liver function regularly 1
Severe infections requiring higher doses: Consider high-dose formulations:
- Augmentin XR 2000/125 mg twice daily for drug-resistant S. pneumoniae 8
- Recent evidence suggests standard 875 mg may be insufficient for some acute sinusitis cases - one study showed 1750 mg IR twice daily had 18% better rapid improvement than 875 mg 9
Common Pitfalls to Avoid
Don't substitute formulations: The 875/125 mg tablet is NOT interchangeable with suspension formulations due to different clavulanate ratios 1
Timing matters: Always instruct patients to take at the start of a meal to reduce GI side effects and optimize absorption 1
Complete the course: Even if symptoms improve early, full course completion is essential to prevent resistance 1
Drug interactions:
False glucose tests: Can cause false-positive urine glucose with certain tests (CLINITEST, Benedict's, Fehling's) - use enzymatic methods instead 1
Adverse Effects
- Most common: Diarrhea (dose-related)
- Severe diarrhea occurs in approximately 5-7% at standard doses 9
- Higher doses (1750-2000 mg) increase severe diarrhea risk to 15-16% 9
Special Populations
Pregnancy: Category B - use only if clearly needed 1
Nursing mothers: Excreted in breast milk - use with caution 1
Elderly (>59 years): No specific dose adjustment for Augmentin 875, but consider renal function