What is the recommended dose of Augmentin (amoxicillin-clavulanate) for treating an abscess?

Recommended Augmentin Dosage for Abscess Treatment

For abscess treatment, amoxicillin-clavulanate (Augmentin) should be dosed at 875/125 mg orally twice daily for 5-6 days in adults. 1

Dosing Guidelines

Adults:

• First-line dosing: 875 mg/125 mg tablet every 12 hours 2
• Alternative dosing: 500 mg/125 mg tablet every 8 hours 2
• Duration: 5-6 days for uncomplicated abscesses 1

Pediatric Patients:

• Age ≥3 months with severe infections: 45 mg/kg/day divided every 12 hours 2
• Age ≥3 months with less severe infections: 25 mg/kg/day divided every 12 hours 2
• Children weighing ≥40 kg: Use adult dosing recommendations 2

Treatment Approach

1. Primary intervention: Incision and drainage is the cornerstone of abscess treatment 1
2. Antibiotic therapy: Should be initiated after drainage to prevent complications 3
3. Coverage considerations: Augmentin provides coverage against both aerobic and anaerobic organisms commonly found in abscesses 1

Special Considerations

• Timing of administration: Take Augmentin at the start of a meal to minimize gastrointestinal intolerance and enhance absorption of clavulanate 2
• MRSA coverage: If MRSA is suspected or prevalent in your area, consider adding or switching to an agent with MRSA coverage such as TMP-SMX or clindamycin 3, 1
• Duration extension: For immunocompromised patients or those with inadequate source control, treatment may be extended up to 7 days 3

Monitoring and Follow-up

• Reassess within 48-72 hours of initiating therapy to evaluate treatment response 1
• Patients with ongoing signs of infection beyond 7 days warrant diagnostic investigation 3
• Monitor for common side effects including diarrhea, nausea, and skin rash

Common Pitfalls to Avoid

• Failure to perform adequate incision and drainage before starting antibiotics 1
• Using antibiotics alone without proper drainage of the abscess 1
• Premature discontinuation of antibiotics before completing the full course 1
• Not considering local resistance patterns when selecting empiric therapy 1

Indications for Alternative Therapy

• Consider alternative antibiotics if patient has:
  • Documented beta-lactam allergy
  • High risk of MRSA infection
  • Failed to respond to initial therapy within 48-72 hours
  • Developed septic shock (requiring IV antibiotics like meropenem, doripenem, or imipenem) 3

Remember that source control through proper drainage remains the most important aspect of abscess management, with antibiotics serving as adjunctive therapy to prevent spread of infection and recurrence.