Oral Dosage of Augmentin for Group B Streptococcal UTI
The recommended oral dose of Augmentin (amoxicillin/clavulanate) for Group B streptococcal urinary tract infection is 40 mg/kg/day of the amoxicillin component divided into three doses, with a maximum of 2,000 mg amoxicillin per day, for 7-14 days. 1
Dosing Recommendations
For adults:
- 875 mg/125 mg every 12 hours OR
- 500 mg/125 mg every 8 hours
For children:
- 40 mg/kg/day of amoxicillin component divided into three doses
- Maximum daily dose: 2,000 mg amoxicillin component
Treatment Duration
The optimal duration of therapy for Group B streptococcal UTI is 7-14 days 1. A minimum of 7 days is necessary as shorter courses (1-3 days) have been shown to be inferior for febrile UTIs.
Rationale for Augmentin Selection
Augmentin is particularly effective for UTIs because:
- The clavulanic acid component inhibits beta-lactamases, reducing resistance in Gram-negative pathogens 2
- It achieves high urinary concentrations with standard dosing
- It provides broad-spectrum coverage that includes Group B streptococcus
Clinical Efficacy
Clinical trials have demonstrated high efficacy rates for Augmentin in treating UTIs:
- In complicated UTIs, Augmentin has shown comparable efficacy between twice-daily and three-times-daily dosing regimens 3
- Success rates of approximately 70% have been reported for amoxicillin-resistant organisms 2
Monitoring and Follow-up
- Assess clinical response within 48-72 hours of initiating therapy
- Consider follow-up urine culture 1-2 weeks after completing therapy if symptoms persist
- Monitor for common side effects, particularly diarrhea (occurs in 14-15% of patients) 3
Special Considerations
- For patients with renal insufficiency, dose adjustment may be required
- For severe infections or patients unable to tolerate oral medication, consider initial parenteral therapy until clinical improvement occurs
- For pregnant patients, Augmentin is generally considered safe but should be prescribed at the lowest effective dose
Potential Pitfalls
- Failure to complete the full course of antibiotics may result in treatment failure or recurrence
- Inadequate dosing may lead to treatment failure and potential development of resistance
- Diarrhea is a common side effect that may lead to discontinuation; consider probiotics as adjunctive therapy
Remember that susceptibility testing is essential to guide therapy, especially in areas with known high resistance rates, to ensure effective treatment of Group B streptococcal infections.