From the FDA Drug Label
- Dosage and Administration Amoxicillin and clavulanate potassium may be taken without regard to meals; however, absorption of clavulanate potassium is enhanced when amoxicillin and clavulanate potassium is administered at the start of a meal. 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. Based on the amoxicillin component, amoxicillin and clavulanate potassium should be dosed as follows: Neonates and Infants Aged <12 weeks (<3 months): The recommended dose of amoxicillin and clavulanate potassium tablet is 30 mg/kg/day divided every 12 hours, based on the amoxicillin component Patients Aged 12 weeks (3 months) and Older: See dosing regimens provided in Table 1.
The dosing for Amoxicillin-Clavulanate (Amoxyclav) is as follows:
- Adults:
- Usual dose: 500 mg/125 mg every 12 hours or 250 mg/125 mg every 8 hours
- For more severe infections: 875 mg/125 mg every 12 hours or 500 mg/125 mg every 8 hours
- Pediatric Patients:
- Neonates and Infants Aged <12 weeks: 30 mg/kg/day divided every 12 hours
- Patients Aged 12 weeks and Older:
- Every 12 hours: 45 mg/kg/day for otitis media, sinusitis, lower respiratory tract infections, and more severe infections; 25 mg/kg/day for less severe infections
- Every 8 hours: 40 mg/kg/day for otitis media, sinusitis, lower respiratory tract infections, and more severe infections; 20 mg/kg/day for less severe infections
- Patients weighing 40 kg or more should be dosed according to adult recommendations 1
From the Research
Amoxyclav (amoxicillin-clavulanate) is typically dosed based on the amoxicillin component, with standard adult dosing at 875mg/125mg twice daily or 500mg/125mg three times daily for most infections, as supported by the most recent and highest quality study 2. The recommended dose for children is 20-40mg/kg/day of the amoxicillin component divided into two or three doses, depending on infection severity. Key points to consider when prescribing Amoxyclav include:
- Treatment duration usually ranges from 7-14 days, with 10 days being common for most respiratory and soft tissue infections.
- The medication should be taken with food to reduce gastrointestinal side effects and improve clavulanate absorption.
- Dosage adjustments are necessary for patients with renal impairment, with reduced frequency recommended for creatinine clearance below 30ml/min.
- Amoxyclav works by combining amoxicillin, which disrupts bacterial cell wall synthesis, with clavulanic acid, which inhibits beta-lactamase enzymes that would otherwise inactivate amoxicillin.
- This combination makes it effective against many beta-lactamase-producing bacteria that would be resistant to amoxicillin alone, including certain strains of Staphylococcus, Haemophilus influenzae, and Escherichia coli, as noted in studies such as 3 and 2. Some specific dosing considerations include:
- For community-acquired pneumonia, a pharmacokinetically enhanced formulation of oral amoxycillin-clavulanate (2000/125 mg), twice daily, may be used, as shown in 2.
- For pediatric use, Amoxicillin/clavulanate 90/6.4 mg/kg/day in two divided doses (Augmentin ES-600) is recommended for persistent or recurrent acute otitis media, as mentioned in 3.