Augmentin IV Dosing Guidelines
The recommended dosage of Augmentin IV (amoxicillin/clavulanate) should be based on the amoxicillin component, with adjustments for infection severity and renal function, typically 1.2g (1g amoxicillin/200mg clavulanate) IV every 8 hours for adults with normal renal function.
Adult Dosing
Standard Dosing for Adults with Normal Renal Function
- Standard dose: 1.2g (1g amoxicillin/200mg clavulanate) IV every 8 hours 1
- For severe infections: May require higher doses or more frequent administration
Renal Impairment Adjustments
- GFR 10-30 mL/min: 500mg/125mg or 250mg/125mg every 12 hours (depending on infection severity) 2
- GFR <10 mL/min: 500mg/125mg or 250mg/125mg every 24 hours (depending on infection severity) 2
- Hemodialysis patients: 500mg/125mg or 250mg/125mg every 24 hours with additional doses during and after dialysis 2
Pediatric Dosing
Based on Age and Weight
- Neonates and infants <12 weeks: 30 mg/kg/day divided every 12 hours (based on amoxicillin component) 2
- Children ≥12 weeks (3 months):
- Children weighing ≥40 kg: Use adult dosing recommendations 2
Infection-Specific Considerations
Respiratory Tract Infections
- Standard adult dose: 1.2g IV every 8 hours for 7-10 days 1, 3
- Consider switching to oral therapy after clinical improvement (typically after 3 days of IV therapy) 1
Intra-abdominal Infections
- For complicated intra-abdominal infections, the pediatric IV dosage is 200-300 mg/kg/day of the piperacillin component divided every 6-8 hours 4
- For adults, standard dosing applies with duration based on clinical response
Urinary Tract Infections
- For uncomplicated UTIs: Amoxicillin 500 mg PO/IV every 8 hours 4
- For complicated UTIs: Standard IV dosing applies
Duration of Therapy
Duration should be based on:
- Type and severity of infection
- Clinical response
- Presence of underlying conditions
Most infections require 7-10 days of therapy, with longer courses for more severe or complicated infections.
Monitoring Considerations
- Renal function: Monitor regularly, especially in patients with pre-existing renal impairment
- Clinical response: Assess within 48-72 hours of initiating therapy
- Adverse effects: Monitor for gastrointestinal side effects, which are the most common
Important Considerations and Pitfalls
Renal function assessment is critical before initiating therapy, as dosage adjustments are necessary for patients with impairment.
Do not use the 875mg/125mg formulation in patients with severe renal impairment (GFR <30 mL/min) 2.
Switching to oral therapy: Consider transitioning to oral therapy when clinically appropriate to reduce hospital stay and costs.
Hemodialysis patients require supplemental dosing both during and after dialysis sessions 2, 5.
Beta-lactamase coverage: The clavulanate component provides coverage against beta-lactamase producing organisms, making it particularly effective for respiratory and urinary tract infections 6, 3.
By following these guidelines and considering patient-specific factors, appropriate Augmentin IV dosing can be determined to optimize therapeutic outcomes while minimizing adverse effects.