Augmentin (Amoxicillin/Clavulanate) Weight-Based Dosing in Adults
For adult patients, the standard dosing of Augmentin (amoxicillin-clavulanate) is 875 mg amoxicillin/125 mg clavulanate twice daily, with a maximum daily dose of 1750 mg of the amoxicillin component. 1
Standard Adult Dosing Formulations
- Regular formulation: 875 mg amoxicillin/125 mg clavulanate twice daily
- Extended-release (XR): 2000 mg amoxicillin/125 mg clavulanate twice daily (for respiratory infections with resistant pathogens) 2, 3
Indication-Specific Dosing
Respiratory tract infections:
- Standard: 875/125 mg twice daily
- For resistant pathogens: 2000/125 mg XR formulation twice daily 2
Skin and soft tissue infections:
- 875/125 mg twice daily 1
Sinusitis:
- 875/125 mg twice daily for 7-10 days 1
Urinary tract infections:
Special Considerations
Renal Impairment
- Dose adjustment required for creatinine clearance <30 mL/min 1
- For severe renal impairment, consider alternative antibiotics or consult with a clinical pharmacist for appropriate dosing
Hepatic Impairment
- Use with caution
- Monitor liver function tests 1
High-Dose Therapy
- For infections caused by S. pneumoniae with reduced penicillin susceptibility, the extended-release formulation (Augmentin XR) provides 2000 mg amoxicillin/125 mg clavulanate twice daily 3
- This maintains plasma amoxicillin concentrations above 4 μg/mL for approximately 49% of the dosing interval 3
Administration Guidelines
- Take with food to minimize gastrointestinal side effects
- Complete the full course of therapy even if symptoms improve before completion
- Space doses evenly throughout the day (approximately every 12 hours for twice-daily dosing)
Monitoring
- Monitor for common side effects: diarrhea, nausea, vomiting
- For prolonged therapy, periodic assessment of renal and hepatic function is recommended
Common Pitfalls to Avoid
- Underdosing: Using insufficient doses for resistant pathogens can lead to treatment failure
- Failure to adjust for renal function: Can lead to drug accumulation and increased risk of side effects
- Premature discontinuation: Stopping therapy early can lead to recurrence and potential resistance development
- Not considering local resistance patterns: Local antimicrobial susceptibility should guide therapy selection
Augmentin remains an important antibiotic for community-acquired infections due to its broad spectrum of activity against both beta-lactamase-producing and non-producing organisms when dosed appropriately.