What is the frequency of taking Augmentin (amoxicillin/clavulanate)?

Augmentin (Amoxicillin/Clavulanate) Dosing Frequency

Augmentin (amoxicillin/clavulanate) should be administered twice daily (every 12 hours) for most adult indications, with the standard adult dose being 875/125 mg twice daily. 1

Standard Dosing Regimens

Adults:

• Standard dose: 875/125 mg twice daily (every 12 hours) 2, 1
• Alternative dosing: 500/125 mg three times daily (every 8 hours) 1
• High-dose formulation: 2000/125 mg (Augmentin XR) twice daily for resistant respiratory infections 3

Children:

• Weight < 40 kg: 45 mg/kg/day divided into two doses (every 12 hours) for moderate to severe infections 1
• Pediatric high-dose formulation: 90 mg/kg/day of amoxicillin component with 6.4 mg/kg/day of clavulanate in two divided doses (Augmentin ES-600) for resistant infections 3

Indication-Specific Dosing

Respiratory Tract Infections:

• Mild/Moderate: 875 mg every 12 hours or 500 mg every 8 hours 1
• Severe: 875 mg every 12 hours or 500 mg every 8 hours 1

Skin/Skin Structure and Genitourinary Infections:

• Mild/Moderate: 500 mg every 12 hours or 250 mg every 8 hours 1
• Severe: 875 mg every 12 hours or 500 mg every 8 hours 1

H. pylori Infection:

• Triple therapy: 1 gram amoxicillin twice daily (every 12 hours) for 14 days (with clarithromycin and lansoprazole) 1
• Dual therapy: 1 gram amoxicillin three times daily (every 8 hours) for 14 days (with lansoprazole) 1

Special Populations

Renal Impairment:

• 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 1
• Hemodialysis: 500 mg or 250 mg every 24 hours plus additional dose during and after dialysis 1
• Note: Patients with 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 1
• Continue treatment for at least 48-72 hours after patient becomes asymptomatic 1
• For Streptococcus pyogenes infections, treat for minimum of 10 days to prevent acute rheumatic fever 1

Common Pitfalls to Avoid

1. Underdosing: Using standard doses for resistant pathogens when high-dose formulations may be needed
2. Inadequate duration: Stopping therapy too soon, especially for streptococcal infections which require 10 days of treatment
3. Renal adjustment errors: Using 875 mg doses in patients with severe renal impairment
4. Poor timing: Not administering with food, which can increase gastrointestinal side effects
5. Inappropriate frequency: Using twice-daily dosing when three-times-daily may be needed for certain indications like H. pylori dual therapy

The twice-daily dosing of Augmentin (875/125 mg) offers better compliance compared to three-times-daily regimens while maintaining efficacy for most common infections, making it the preferred dosing frequency for most adult indications.