Amoxicillin 875 mg Twice Daily Dosing
Yes, amoxicillin 875 mg twice daily is an appropriate dosing regimen for most adult infections requiring amoxicillin therapy. This dosing schedule is FDA-approved and supported by clinical evidence 1.
Appropriate Dosing of Amoxicillin 875 mg
Standard Adult Dosing
- For mild to moderate infections: 875 mg every 12 hours (twice daily) 1
- For severe infections: 875 mg every 12 hours or 500 mg every 8 hours 1
- For lower respiratory tract infections: 875 mg every 12 hours 1
Evidence Supporting Twice-Daily Dosing
- Multiple studies have confirmed that 875 mg twice daily dosing is as effective as more frequent dosing:
- A randomized clinical trial demonstrated that amoxicillin/clavulanate 875/125 mg given every 12 hours is as effective and safe as every 8-hour dosing for lower respiratory tract infections 2
- Another study showed clinical success rates of 92.4% for twice-daily regimens versus 94.2% for three-times-daily regimens, confirming treatment equivalence 3
- A Cochrane review found that once or twice daily dosing of amoxicillin (with or without clavulanate) was comparable to three times daily dosing for acute otitis media 4
Clinical Applications
Common Indications for Amoxicillin 875 mg Twice Daily
- Lower respiratory tract infections 1
- Ear/nose/throat infections (moderate to severe) 1
- Skin/skin structure infections 1
- Genitourinary tract infections 1
Treatment Duration
- Most infections: Minimum of 48-72 hours beyond symptom resolution 1
- Streptococcal infections: Minimum of 10 days to prevent acute rheumatic fever 1
- H. pylori eradication: 14 days (as part of combination therapy) 1
Important Considerations
Renal Dosing Adjustments
- For patients with GFR 10-30 mL/min: Reduce to 500 mg or 250 mg every 12 hours 1
- For patients with GFR <10 mL/min: Reduce to 500 mg or 250 mg every 24 hours 1
- Patients with severe renal impairment (GFR <30 mL/min) should NOT receive the 875 mg dose 1
Administration Tips
- Take at the start of a meal to minimize gastrointestinal intolerance 1
- Ensure adequate hydration during treatment
Common Adverse Effects
- Gastrointestinal symptoms (diarrhea, nausea)
- Twice-daily dosing may result in fewer reports of moderate or severe diarrhea compared to three-times-daily dosing 2
Clinical Pearl
The twice-daily dosing of amoxicillin 875 mg offers the advantage of improved patient compliance compared to more frequent dosing schedules while maintaining equivalent clinical efficacy. This makes it an excellent choice for outpatient management of susceptible infections.