Recommended Dosage of Augmentin (Amoxicillin/Clavulanate) DDS
The standard dosage of Augmentin (amoxicillin-clavulanate) for adults is 875 mg amoxicillin/125 mg clavulanate twice daily for most common infections, with a maximum daily dose of 1750 mg amoxicillin component per day. 1
Adult Dosing Guidelines
Standard Adult Dosing
- 875 mg amoxicillin/125 mg clavulanate twice daily for most infections 1
- Alternative dosing: 500 mg/125 mg three times daily 2
- High-dose formulation: 2000 mg/125 mg twice daily for severe infections 2, 1
Indication-Specific Dosing
Community-Acquired Pneumonia:
- Outpatients with comorbidities: 875 mg/125 mg twice daily OR 500 mg/125 mg three times daily 2
- Duration: 7-10 days
COPD Exacerbations:
- Standard dose: 875 mg/125 mg twice daily
- High-dose formulation (2000 mg/125 mg twice daily) may be useful for resistant strains 2
Skin and Soft Tissue Infections:
- 875 mg/125 mg twice daily 1
Sinusitis:
- 875 mg/125 mg twice daily for 7-10 days 1
Complicated UTI:
- 875 mg/125 mg twice daily for 10-14 days 1
Pediatric Dosing Guidelines
- Standard pediatric dosing: 40 mg/kg/day of amoxicillin component in three divided doses 1
- For resistant pathogens: 90 mg/kg/day of amoxicillin component in two divided doses (high-dose formulation) 1, 3
- Maximum pediatric dose: 4000 mg/day 1
- For Group A streptococcal carrier treatment: 40 mg/kg/day in three divided doses for 10 days 1
Special Considerations
Dose Adjustments
- Renal Impairment: Dose adjustment required for patients with creatinine clearance <30 mL/min 1
- Hepatic Impairment: Monitor liver function 1
Duration of Therapy
- Complete the full course of therapy even if symptoms improve before completion to prevent recurrence and potential resistance development 1
- Standard duration is typically 7-14 days depending on indication
Potential Pitfalls and Caveats
- Insufficient Dosing: Using inadequate doses for resistant pathogens can lead to treatment failure 1
- Failure to Adjust for Renal Function: Can lead to accumulation and increased risk of side effects 1
- Formulation Confusion: Note that two 250 mg tablets of amoxicillin-clavulanate are not equivalent to one 500 mg tablet, as both contain 125 mg of clavulanic acid 2
Resistance Considerations
- Local resistance patterns should guide therapy, particularly for respiratory infections 1
- High-dose formulations were developed specifically to address penicillin-resistant Streptococcus pneumoniae 4
- Augmentin is often an effective second-line option for patients who have failed initial therapy with other antibiotics 1
The twice-daily dosing regimen (875/125 mg) is generally preferred over three-times-daily dosing (500/125 mg) when possible, as it may improve adherence and has been associated with fewer gastrointestinal side effects 3.