What is the recommended dosing of Augmentin (amoxicillin-clavulanate) for the treatment of cellulitis?

From the Guidelines

Augmentin (amoxicillin-clavulanate) should be dosed at 875 mg amoxicillin/125 mg clavulanate orally twice daily for the treatment of cellulitis, with a typical treatment duration of 5-7 days, as recommended by the most recent guidelines 1. The dosing of Augmentin for cellulitis is based on the severity of the infection and the patient's age and weight. For adults, the recommended dose is 875 mg amoxicillin/125 mg clavulanate orally twice daily, or alternatively 500 mg amoxicillin/125 mg clavulanate orally three times daily. For children, the dosing is based on the amoxicillin component at 25-45 mg/kg/day divided into two doses (for the 875/125 mg formulation) or 20-40 mg/kg/day divided into three doses (for other formulations) 1. Key considerations for the treatment of cellulitis with Augmentin include:

• The patient should complete the full course of treatment, even if symptoms improve before completion, to ensure that the infection is fully cleared.
• Augmentin should be taken with food to minimize gastrointestinal side effects.
• Patients should be monitored for common side effects, including diarrhea, nausea, and rash.
• If symptoms worsen despite 48 hours of treatment, the patient should seek medical attention as this may indicate treatment failure or incorrect diagnosis. The choice of Augmentin for cellulitis is based on its effectiveness against Streptococcus and Staphylococcus species, including some beta-lactamase producing strains, through the addition of clavulanate which inhibits beta-lactamase enzymes that would otherwise break down amoxicillin 1.

From the FDA Drug Label

2.1 Adults The usual adult dose is one 500 mg/125 mg amoxicillin and clavulanate potassium tablet every 12 hours or one 250 mg/125 mg amoxicillin and clavulanate potassium tablet every 8 hours For more severe infections and infections of the respiratory tract, the dose should be one 875 mg/125 mg amoxicillin and clavulanate potassium tablet every 12 hours or one 500 mg/125 mg amoxicillin and clavulanate potassium tablet every 8 hours.

The recommended dosing of Augmentin (amoxicillin-clavulanate) for the treatment of cellulitis is not explicitly stated in the provided drug label. However, based on the information provided for more severe infections, the dose could be one 875 mg/125 mg amoxicillin and clavulanate potassium tablet every 12 hours or one 500 mg/125 mg amoxicillin and clavulanate potassium tablet every 8 hours 2.

• Key considerations:
  • The dosing may vary depending on the severity of the infection.
  • It is essential to follow the recommended dosing regimen to minimize the potential for gastrointestinal intolerance.
  • The drug label does not provide specific dosing recommendations for cellulitis, so caution should be exercised when determining the appropriate dose.

From the Research

Augmentin Dosing for Cellulitis

• The recommended dosing of Augmentin (amoxicillin-clavulanate) for the treatment of cellulitis is not directly stated in the provided studies.
• However, study 3 mentions that a combination therapeutic regimen of amoxicillin + clavulanic acid was the most commonly used treatment option for erysipelas or bacterial cellulitis, and this therapy was linked with the shortest duration of stay in the hospital.
• The study 3 does not specify the exact dosing of Augmentin, but it suggests that the combination of amoxicillin and clavulanic acid is an effective treatment option for cellulitis.
• Study 4 provides information on the dosing of Augmentin for other types of infections, such as urogenital infections, where the drug was administered in a single dose of 375 mg thrice daily for 6 to 12 days.
• It is essential to note that the dosing of Augmentin for cellulitis may vary depending on the severity of the infection, patient age, and other factors, and should be determined by a healthcare professional.

Factors Affecting Treatment Duration

• Study 5 found that the duration of antibiotic therapy for cellulitis is associated with patient age, C-reactive protein levels, coexisting diabetes mellitus, and coexisting blood stream infection.
• Study 6 suggests that the addition of an oral anti-inflammatory agent to antibiotic treatment can hasten the resolution of cellulitis-related inflammation.
• Study 3 found that patients with chills on admission, coexisting chronic venous insufficiency of the lower limbs, and anemia were hospitalized for a significantly longer period than those without these conditions.

Comparison of Antibiotic Treatments

• Study 7 found that the efficacy of treatment of cellulitis or erysipelas was similar with a beta-lactam (such as penicillin or cephalexin) and a macrolide or lincosamide (such as erythromycin or clindamycin).
• Study 3 found that combination therapy with amoxicillin + clavulanic acid was linked with the shortest stay in the hospital, and was least often associated with the need to use other antibacterial agents.