What is the recommended injectable (IV) dosage of Augmentin (amoxicillin/clavulanate)?

Injectable Augmentin (Amoxicillin/Clavulanate) Dosage Recommendations

For adults, the recommended intravenous (IV) dose of Augmentin is 1.2 g (1000 mg amoxicillin/200 mg clavulanate) every 8 hours, with adjustments needed for renal impairment. 1

Adult Dosing

• Standard adult dose: 1.2 g IV every 8 hours
• Maximum daily dose: 3.6 g
• Duration: Typically 7-10 days depending on infection type and clinical response

Renal Adjustment for Adults:

• CrCl 20-40 mL/min: 1.2 g IV every 12 hours
• CrCl <20 mL/min: 1.2 g IV every 24 hours
• Hemodialysis patients: Additional dose after dialysis

Pediatric Dosing

• Neonates and infants <3 months: Not recommended
• Children >3 months:
  • Standard dose: 30 mg/kg/dose of amoxicillin component IV every 8 hours 1
  • Severe infections: 50 mg/kg/dose IV every 8 hours
  • Maximum dose: 1.2 g per dose

Special Pediatric Considerations:

• For postmenstrual age >30 weeks: 80 mg/kg/dose (of piperacillin component) IV every 6 hours 1
• For severe infections like pneumonia: Higher doses may be required

Clinical Applications

Respiratory Tract Infections:

• Community-acquired pneumonia: 1.2 g IV every 8 hours
• Duration: 7-10 days 1

Intra-abdominal Infections:

• Standard dose: 1.2 g IV every 8 hours
• Duration: 4-7 days after adequate source control 1
• For immunocompromised or critically ill patients: Up to 10 days

Skin and Soft Tissue Infections:

• Standard dose: 1.2 g IV every 8 hours
• Duration: 7-14 days depending on severity

Important Considerations

• Monitor for adverse effects: Diarrhea, rash, and elevated liver enzymes are common
• Transition to oral therapy: When clinically improved and able to tolerate oral medications
• Culture results: Tailor therapy based on culture and susceptibility results when available
• Beta-lactam allergy: Avoid in patients with history of severe immediate hypersensitivity reactions to penicillins

Pitfalls to Avoid

1. Underdosing in severe infections: For severe infections, ensure adequate dosing to achieve therapeutic concentrations
2. Failure to adjust for renal function: Augmentin is eliminated primarily by the kidneys, so dosage adjustment is essential in renal impairment
3. Prolonged IV therapy: Switch to oral therapy when appropriate to reduce risk of catheter-related complications
4. Overlooking resistance patterns: Consider local resistance patterns when selecting empiric therapy
5. Inadequate source control: For intra-abdominal infections, surgical drainage or other source control measures are essential for successful treatment

Remember that while appropriate antibiotic therapy is crucial, source control remains the cornerstone of treatment for many infections requiring IV antibiotics.