Should I resume Augmentin (amoxicillin-clavulanate) for my sinus infection despite side effects?

Management of Sinus Infection After Partial Augmentin Course

You should not resume Augmentin due to your improving symptoms and the significant side effects you experienced, as continuing antibiotics is unnecessary when clinical improvement is already occurring.

Assessment of Your Current Situation

Your clinical presentation suggests a resolving infection:

• You're on day 8 with mostly resolved symptoms
• Clear mucus indicates resolution of acute bacterial phase
• Yellow/green phlegm with cough that started on day 5 is consistent with post-nasal drip from resolving sinusitis
• You've already taken 3 doses of Augmentin (amoxicillin-clavulanate)
• You're experiencing significant side effects (diarrhea and abdominal pain)

Why Discontinuing Antibiotics is Appropriate

1. Clinical Improvement: You report that your infection "has mostly resolved" which indicates a positive treatment response 1. Guidelines state that when patients show symptomatic improvement, continuing antibiotics may not be necessary.

2. Side Effect Considerations: The FDA label for Augmentin notes that diarrhea and abdominal discomfort are common side effects 2. Continuing despite these symptoms increases risk of more severe gastrointestinal issues.

3. Bacterial vs. Viral Components: While your culture showed Klebsiella oxytoca (which is sensitive to Augmentin), your improving symptoms suggest your immune system is effectively managing the infection. Most sinus infections have both viral and bacterial components, and yours appears to be resolving 1.

Monitoring Your Recovery

• Continue supportive care measures:

  • Adequate hydration
  • Saline nasal irrigation
  • Rest
  • Over-the-counter pain relievers if needed
  • Warm facial packs or steamy showers for comfort 1

• Watch for warning signs that would require medical reassessment:

  • Worsening symptoms after 72 hours
  • Development of high fever
  • Severe headache
  • Visual changes or severe facial pain 1, 3

Special Considerations

• Klebsiella finding: While this organism was cultured, your clinical improvement suggests it's being adequately addressed by your immune system and the antibiotic doses you've already taken.

• Partial antibiotic course: While guidelines typically recommend completing a full course of antibiotics (10-14 days) 1, 3, this recommendation must be balanced against significant side effects and clinical improvement.

• Antibiotic side effects: The diarrhea and abdominal pain you're experiencing are among the most common side effects of Augmentin 2. Continuing despite these symptoms increases your risk of developing more severe complications like Clostridioides difficile infection.

When to Seek Further Medical Attention

Contact your healthcare provider if:

• Symptoms worsen or return after improving
• Diarrhea becomes severe or contains blood
• You develop new symptoms like high fever or severe headache 2

This approach prioritizes your quality of life and recognizes that continuing antibiotics despite significant side effects and improving symptoms is unlikely to provide additional benefit.