Should I resume Augmentin (amoxicillin-clavulanate) after missing doses due to GI side effects, given the culture results show heavy growth of Klebsiella oxytoca susceptible to Augmentin (amoxicillin-clavulanate)?

Management of Sinus Infection with Klebsiella oxytoca

You should resume taking Augmentin (amoxicillin-clavulanate) to complete your course of treatment since the culture shows heavy growth of Klebsiella oxytoca that is susceptible to this antibiotic. 1

Rationale for Resuming Augmentin

• The FDA drug label for amoxicillin-clavulanate clearly states that skipping doses or not completing the full course of therapy may decrease the effectiveness of immediate treatment and increase the likelihood of bacterial resistance 1
• Your culture results confirm heavy growth of Klebsiella oxytoca that is susceptible to Augmentin, making it the appropriate targeted therapy
• While you've missed 4 doses, resistance is unlikely to have developed from the initial 3 doses you took, especially since the organism remains susceptible according to your culture results

Managing GI Side Effects

Since you experienced GI side effects previously, consider these strategies:

• Take each dose with food to reduce gastrointestinal upset 1
• Space doses evenly throughout the day (every 12 hours for the 875mg formulation)
• Stay well-hydrated
• Consider over-the-counter probiotics (taken at least 2 hours apart from antibiotics)
• If diarrhea becomes severe or persists more than 2-3 days, contact your physician 1

Monitoring Your Recovery

Monitor for these signs that would warrant immediate medical attention:

• Worsening symptoms after resuming antibiotics for 72 hours 2
• Development of high fever
• Severe headache or visual changes
• Severe facial pain
• Bloody diarrhea (could indicate antibiotic-associated hemorrhagic colitis, which has been reported with K. oxytoca) 3, 4

Duration of Treatment

• Complete the full 7-day course as originally prescribed
• Patients who have ongoing signs of infection beyond 7 days of antibiotic treatment warrant further diagnostic investigation 5
• Continue supportive care measures including adequate hydration, saline nasal irrigation, rest, and over-the-counter pain relievers if needed 2

Risk of Resistance

The risk of developing resistance after taking only 3 doses is low, particularly since:

1. The organism remains susceptible to Augmentin according to your culture
2. You haven't been on multiple courses of antibiotics
3. Klebsiella oxytoca can develop resistance to amoxicillin-clavulanate but typically requires prolonged or repeated exposure 6

In summary, the benefits of completing your antibiotic course outweigh the risks of stopping treatment, especially with confirmed bacterial growth on culture. Try taking the medication with food to minimize GI effects, and contact your healthcare provider if symptoms worsen or severe side effects develop.