What is the dosage and treatment regimen for Augmentin (amoxicillin-clavulanate)?

Augmentin (Amoxicillin-Clavulanate) Dosage and Treatment Regimen

For adults with infections, Augmentin should be dosed at 875 mg amoxicillin/125 mg clavulanate twice daily or 500 mg amoxicillin/125 mg clavulanate every 8 hours for 7-14 days, depending on the type and severity of infection. 1

Adult Dosing Regimens

Standard Dosing Options:

• Mild to Moderate Infections:

  • 500 mg amoxicillin/125 mg clavulanate every 12 hours OR
  • 250 mg amoxicillin/125 mg clavulanate every 8 hours 1

• Severe Infections:

  • 875 mg amoxicillin/125 mg clavulanate every 12 hours OR
  • 500 mg amoxicillin/125 mg clavulanate every 8 hours 1

High-Dose Formulations:

• For respiratory infections with drug-resistant pathogens:

  • 2000 mg amoxicillin/125 mg clavulanate twice daily (Augmentin XR) 2, 3

• For H. pylori infection:

  • Triple therapy: 1 gram amoxicillin, 500 mg clarithromycin, and 30 mg lansoprazole, all twice daily for 14 days
  • Dual therapy: 1 gram amoxicillin and 30 mg lansoprazole, each three times daily for 14 days 1

Pediatric Dosing Regimens

Standard Dosing:

• Children ≥3 months and <40 kg:

  • Mild/Moderate infections: 25 mg/kg/day of amoxicillin component divided every 12 hours or 20 mg/kg/day divided every 8 hours
  • Severe infections: 45 mg/kg/day of amoxicillin component divided every 12 hours or 40 mg/kg/day divided every 8 hours 1

• Children <3 months:

  • Maximum 30 mg/kg/day of amoxicillin component divided every 12 hours due to immature renal function 1

High-Dose Formulation:

• For persistent/recurrent otitis media:
  • 90 mg/kg/day of amoxicillin component with 6.4 mg/kg/day of clavulanate in two divided doses (Augmentin ES-600) 3

Duration of Treatment

• Treatment should continue for a minimum of 48 to 72 hours beyond symptom resolution 1
• For respiratory tract infections: 7-14 days typically recommended 2
• For Streptococcus pyogenes infections: minimum 10 days to prevent acute rheumatic fever 1
• For H. pylori eradication: 14 days 1

Renal Dosing Adjustments

• GFR 10-30 mL/min: 500 mg or 250 mg every 12 hours based on infection severity
• GFR <10 mL/min: 500 mg or 250 mg every 24 hours based on infection severity
• Hemodialysis: 500 mg or 250 mg every 24 hours plus additional dose during and after dialysis 1
• Patients with severe renal impairment (GFR <30 mL/min) should NOT receive the 875 mg dose 1

Administration Guidelines

• Take at the start of a meal to minimize gastrointestinal intolerance 1
• For oral suspension: shake well before using; refrigeration preferred but not required
• Reconstituted suspension must be discarded after 14 days 1

Clinical Considerations

• Augmentin provides coverage against beta-lactamase-producing organisms that would otherwise be resistant to amoxicillin alone 4, 3
• The addition of clavulanate does not affect activity against S. pneumoniae but preserves amoxicillin activity against beta-lactamase producers 2
• Higher doses are particularly important for areas with high prevalence of drug-resistant S. pneumoniae 3

Augmentin remains a cornerstone antibiotic for community-acquired respiratory tract infections, urinary tract infections, and skin/soft tissue infections due to its broad spectrum of activity and favorable pharmacokinetic profile 3, 5.