When to Restart Augmentin After Initial Course
If symptoms of acute bacterial rhinosinusitis worsen after initial improvement, you can restart Augmentin immediately, as guidelines specifically identify this "double worsening" pattern as an indication for antibiotic therapy. 1
Understanding When to Restart Treatment
The American Academy of Otolaryngology-Head and Neck Surgery guidelines provide clear direction for managing worsening symptoms:
- Double worsening pattern: If symptoms worsen within 10 days after an initial improvement, this is a specific diagnostic criterion for acute bacterial rhinosinusitis (ABRS) requiring antibiotic treatment 1
- Immediate restart: There is no mandatory waiting period between courses when symptoms clearly worsen after initial improvement 1
- Treatment failure: If symptoms worsen at any time during watchful waiting, antibiotics should be started immediately 1
Monitoring After Restarting Antibiotics
When restarting Augmentin:
- Expect significant improvement within 72 hours of restarting treatment 2
- Monitor for:
- Continued worsening despite antibiotics
- No improvement after 72 hours
- Development of new symptoms
Duration of Second Course
For the second course of Augmentin:
- Complete a full 5-10 day course as recommended for ABRS 1
- Consider a shorter course (5-7 days) if symptoms are mild to moderate, as shorter courses have fewer side effects while maintaining efficacy 1
Important Considerations
- Treatment failure: If you previously completed a full course of Augmentin and symptoms return or worsen, your provider may need to change antibiotics rather than repeating the same one 1
- Side effect monitoring: Watch for common side effects like diarrhea, nausea, or rash, which occur in approximately 10-12% of patients 1
When to Seek Medical Attention
Contact your healthcare provider immediately if:
- Symptoms worsen despite 72 hours of antibiotic therapy
- You develop severe side effects (severe diarrhea, rash)
- New symptoms develop (severe headache, visual changes, altered mental status)
Common Pitfalls to Avoid
- Don't delay treatment when symptoms clearly worsen after initial improvement - this "double worsening" pattern is a strong indicator of bacterial infection requiring antibiotics 1
- Don't stop antibiotics early when feeling better - complete the full prescribed course to prevent recurrence and antibiotic resistance 2
- Don't self-diagnose persistent symptoms as "just a sinus infection" - persistent symptoms may indicate complications requiring different treatment
Following these guidelines will help ensure appropriate and timely treatment while minimizing risks of antibiotic overuse or treatment failure.