Maximum Daily Dose of Augmentin (Amoxicillin-Clavulanate)
The maximum daily dose of Augmentin (amoxicillin-clavulanate) for adults is 4000 mg of the amoxicillin component per day. 1
Adult Dosing Guidelines
The standard adult dosing regimens for Augmentin include:
- Standard dosing: 875 mg amoxicillin/125 mg clavulanate twice daily (1750 mg amoxicillin component per day) 2
- High-dose formulation: 2000 mg amoxicillin/125 mg clavulanate twice daily (4000 mg amoxicillin component per day) 3
- Alternative dosing: 500 mg amoxicillin/125 mg clavulanate three times daily (1500 mg amoxicillin component per day) 4
Pediatric Dosing Guidelines
For pediatric patients, the maximum daily dose depends on weight and indication:
- Standard pediatric dosing: 90 mg/kg/day of amoxicillin component divided into 2-3 doses 5
- Maximum pediatric dose: 4000 mg/day of amoxicillin component 5
Dosing Based on Infection Type
Dosing varies by infection type:
- Respiratory tract infections: 875 mg twice daily or 500 mg three times daily 6
- Severe infections: 875 mg twice daily or 500 mg every 8 hours 1
- H. pylori infection: 1000 mg amoxicillin twice daily (with clarithromycin and lansoprazole) or 1000 mg three times daily (with lansoprazole alone) 1
Dosing in Special Populations
Renal Impairment
Dose adjustment is required for patients with impaired renal function:
- GFR 10-30 mL/min: 500 mg or 250 mg every 12 hours, depending on infection severity 1
- GFR <10 mL/min: 500 mg or 250 mg every 24 hours, depending on infection severity 1
- Hemodialysis patients: 500 mg or 250 mg every 24 hours with additional doses during and after dialysis 1
Important Considerations
- Patients with severe renal impairment (GFR <30 mL/min) should NOT receive the 875 mg dose 1
- For patients with hepatic impairment, liver function should be monitored and the medication used with caution 2
Clinical Pearls
- Augmentin should be taken at the start of a meal to minimize gastrointestinal intolerance 1
- Treatment should generally continue for 48-72 hours beyond symptom resolution 1
- For Streptococcus pyogenes infections, a minimum 10-day treatment course is recommended to prevent acute rheumatic fever 1
- The pharmacokinetically enhanced formulation (Augmentin XR) was developed specifically to overcome resistance in S. pneumoniae with reduced penicillin susceptibility 3
By following these dosing guidelines, clinicians can optimize therapeutic outcomes while minimizing adverse effects when prescribing Augmentin.