From the FDA Drug Label
Infections of the Skin and Skin Structure Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours Severe 875 mg every 12 hours or 500 mg every 8 hours 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours
The recommended dose of amoxicillin for treating skin infections is:
- Mild/Moderate: 500 mg every 12 hours or 250 mg every 8 hours for adults, and 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours for pediatric patients.
- Severe: 875 mg every 12 hours or 500 mg every 8 hours for adults, and 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours for pediatric patients 1.
From the Research
For skin infections, the recommended dose of amoxicillin for adults is typically not the first choice due to beta-lactamase resistance, but when used, it's often in the form of amoxicillin-clavulanate, dosed at 875/125 mg twice daily or 500/125 mg three times daily for adults, as seen in studies such as 2. The choice of antibiotic for skin infections should prioritize coverage of common pathogens such as Staphylococcus aureus and Streptococcus pyogenes, considering the increasing prevalence of beta-lactamase-producing bacteria.
- Amoxicillin alone may not be effective against many skin pathogens due to beta-lactamase production, which inactivates the drug.
- Amoxicillin-clavulanate is generally more appropriate for skin infections because clavulanic acid inhibits beta-lactamase enzymes, thereby protecting amoxicillin from degradation.
- The dosing for amoxicillin-clavulanate can vary, but common regimens include 875/125 mg twice daily or 500/125 mg three times daily for adults, with treatment duration typically ranging from 7 to 10 days.
- It's crucial to complete the full prescribed course of antibiotics, even if symptoms improve earlier, to ensure complete eradication of the infection and prevent antibiotic resistance.
- Side effects of amoxicillin-clavulanate may include diarrhea, nausea, and rash; taking the medication with food can help reduce stomach upset, and any rash should prompt immediate cessation of the medication and consultation with a healthcare provider due to the risk of an allergic reaction, as noted in various studies including 3 and 4. Given the most recent and highest quality evidence, such as the study from 2 published in 2021, which discusses the current role of orally administered amoxicillin/clavulanate in outpatient therapy, including for skin infections, the use of amoxicillin-clavulanate at appropriate doses is supported for the treatment of skin infections, considering its efficacy and safety profile.