Effectiveness of Augmentin for Urinary Tract Infections
Yes, Augmentin (amoxicillin/clavulanate) is effective against many common urinary tract infections, particularly those caused by beta-lactamase-producing organisms that would otherwise be resistant to amoxicillin alone.
Antimicrobial Coverage
Augmentin is specifically indicated for genitourinary tract infections caused by susceptible organisms including:
- Escherichia coli (most common UTI pathogen)
- Proteus mirabilis
- Enterococcus faecalis 1
The addition of clavulanic acid to amoxicillin provides protection against beta-lactamase enzymes, extending coverage to many organisms that would otherwise be resistant to amoxicillin alone 2
Clinical Evidence for UTI Treatment
Clinical trials have demonstrated approximately 70% success rates when using Augmentin to treat UTIs caused by amoxicillin-resistant organisms 2
Studies in patients with complicated UTIs (including those with spinal injuries) showed 100% bacteriological success rate 24 hours after therapy and 69% success rate 8 days after therapy 3
In a comparative study with co-trimoxazole, Augmentin achieved an 83% cure rate for uncomplicated UTIs, though this was slightly lower than co-trimoxazole's effectiveness in that particular study 4
Dosing Considerations
For uncomplicated UTIs, the European Association of Urology guidelines include amoxicillin-clavulanate at 40-90 mg/kg/day divided in 2-3 doses for 5-7 days 5
For complicated UTIs, treatment duration is typically longer:
Important Limitations and Considerations
Local resistance patterns should always be considered before prescribing
- Some regions may have high resistance rates to Augmentin
- Culture and susceptibility testing should guide therapy whenever possible 5
Potential side effects include:
Drug interactions to be aware of:
- Oral anticoagulants (may require monitoring and dose adjustment)
- Allopurinol (increased risk of rashes)
- Oral contraceptives (may reduce efficacy) 1
Alternative Options When Augmentin Is Not Appropriate
For patients who cannot take Augmentin, alternatives include:
- Fluoroquinolones (if local resistance <10%)
- Trimethoprim-sulfamethoxazole
- Cephalosporins 5
For complicated UTIs with systemic symptoms, the European Association of Urology recommends:
- Amoxicillin plus an aminoglycoside
- A second-generation cephalosporin plus an aminoglycoside
- An intravenous third-generation cephalosporin 6
In summary, Augmentin is an effective treatment option for many UTIs, particularly when beta-lactamase-producing organisms are suspected or confirmed. Its broad spectrum of activity makes it suitable for both uncomplicated and complicated UTIs when the causative organisms are susceptible.