Recommended Dosage for Augmentin (Amoxicillin/Clavulanate)
The standard adult dose for Augmentin is 875 mg amoxicillin/125 mg clavulanate twice daily or 500 mg amoxicillin/125 mg clavulanate three times daily for most common infections, with pediatric dosing based on weight at 40-90 mg/kg/day of the amoxicillin component divided into 2-3 doses. 1
Adult Dosing
Standard Dosing
- Conventional formulation: 875/125 mg twice daily or 500/125 mg three times daily 1
- Maximum daily dose: 4000 mg amoxicillin component 1
- For severe infections: 1.2 g IV every 8 hours 1
Special Situations
- For intra-abdominal infections with adequate source control: 1.2 g IV every 8 hours 1
- For community-acquired pneumonia (moderate severity): 1.2 g IV every 8 hours 1
- For aspiration pneumonia: 1-2 g PO every 12 hours or 1.2 g IV every 8 hours 1
Pediatric Dosing
Standard Dosing
- 40-90 mg/kg/day of amoxicillin component divided into 2-3 doses 1
- For streptococcal pharyngitis: 40 mg/kg/day in three doses (maximum 2,000 mg amoxicillin per day) 1
Special Situations
- For recurrent/persistent acute otitis media: 90/6.4 mg/kg/day in two divided doses (high-dose formulation) 2, 3
- For H. influenzae infections: 45 mg/kg/day of amoxicillin component in 3 doses or 90 mg/kg/day in 2 doses if β-lactamase producing 1
Duration of Therapy
- Most respiratory tract infections: 5-7 days 1
- Streptococcal pharyngitis: 10 days 1
- Urinary tract infections: 3-7 days 1
- Intra-abdominal infections: 4 days in immunocompetent patients with adequate source control; up to 7 days in immunocompromised or critically ill patients 1
Clinical Pearls and Caveats
- Dosing should be adjusted in renal impairment - reduce dose or extend interval based on creatinine clearance 1
- Take with food to minimize gastrointestinal side effects 2, 3
- Twice-daily dosing is associated with better compliance and fewer gastrointestinal side effects than three-times-daily dosing 2
- For penicillin-resistant S. pneumoniae, use high-dose formulations (90/6.4 mg/kg/day in children) 2, 3
- The high-dose formulation (Augmentin ES-600 for pediatrics or Augmentin XR for adults) provides better coverage against penicillin-intermediate and resistant S. pneumoniae 2, 3
Common Adverse Effects
- Gastrointestinal disturbances (diarrhea, nausea, vomiting) are most common 2
- Diarrhea is generally less frequent with twice-daily than with three-times-daily regimens 2
- Hypersensitivity reactions may occur in patients with penicillin allergy 1
Remember that dosing may need to be adjusted based on the specific infection site, severity, and local resistance patterns. For multidrug-resistant organisms, alternative antibiotics may be necessary based on susceptibility testing.