IV Augmentin Dosing for Adults
The recommended intravenous (IV) dose of Augmentin (amoxicillin-clavulanate) for adults is 1.2 grams (1 g amoxicillin plus 200 mg clavulanic acid) administered every 8 hours.
Standard Dosing Regimen
For most adult infections requiring IV therapy, the standard dosing is:
- 1.2 g IV every 8 hours (equivalent to 3.6 g total daily dose)
This dosing is supported by clinical evidence showing excellent efficacy and tolerability in treating various infections 1.
Specific Clinical Scenarios
For Complicated Skin and Soft Tissue Infections
- Amoxicillin-clavulanate: 1.2 g IV every 8 hours 2
- Duration typically 7-10 days depending on clinical response
For Group A Streptococcal Infections (Chronic Carriers)
- Oral amoxicillin-clavulanate: 40 mg/kg/day of amoxicillin component in three divided doses (maximum 2,000 mg amoxicillin per day) 2
- When transitioning from IV to oral therapy, maintain appropriate dosing ratios
Special Populations
Renal Impairment
Dose adjustment is required in patients with renal impairment:
- For creatinine clearance 10-30 mL/min: 1.2 g IV every 12 hours
- For creatinine clearance <10 mL/min: 1.2 g IV every 24 hours
- For hemodialysis patients: 1.2 g IV every 24 hours, with additional dose after dialysis 3
Hepatic Impairment
- Use with caution in patients with evidence of hepatic dysfunction
- Monitor liver function tests regularly
- No specific dose adjustment is recommended, but clinical monitoring is essential
Administration Guidelines
- Administer by slow IV injection over 3-4 minutes, or
- Dilute in 50-100 mL of compatible IV solution and infuse over 30 minutes
- Avoid rapid bolus administration to minimize vein irritation
Clinical Pearls and Pitfalls
- Pitfall: Underdosing in severe infections. For serious infections, ensure full dose of 1.2 g every 8 hours is administered.
- Pitfall: Failure to adjust dosing in renal impairment can lead to drug accumulation and increased risk of adverse effects.
- Pearl: When transitioning from IV to oral therapy, the standard oral dose is 875/125 mg twice daily.
- Pearl: Monitor for signs of allergic reactions, especially in patients with known penicillin allergy.
Monitoring
- Clinical response (fever, white blood cell count, clinical symptoms)
- Renal function (especially in prolonged therapy)
- Liver function tests periodically during extended treatment courses
- Signs of superinfection or Clostridium difficile-associated diarrhea
The IV formulation of Augmentin provides excellent coverage against many common pathogens, including beta-lactamase producing organisms, making it an effective choice for empiric therapy in many moderate to severe infections requiring parenteral antibiotics.