What is the recommended dosage of Augmentin (amoxicillin/clavulanate) for treating urinary tract infections (UTIs)?

Augmentin Dosage for Urinary Tract Infections

For standard urinary tract infections in adults, Augmentin (amoxicillin/clavulanate) should be administered at a dose of 500 mg (amoxicillin component) every 8 hours or 875 mg every 12 hours for 7-10 days. 1, 2, 3

Adult Dosing Recommendations

• For mild to moderate UTIs: 500 mg every 12 hours or 250 mg every 8 hours 1
• For severe UTIs: 875 mg every 12 hours or 500 mg every 8 hours 1
• Duration of therapy: 7-10 days for uncomplicated UTIs, with treatment continuing for at least 48-72 hours after the patient becomes asymptomatic 1, 3
• Administration: Take at the start of a meal to minimize gastrointestinal intolerance 1

Pediatric Dosing Recommendations

• For children ≥3 months and <40 kg:

  • Mild/moderate infections: 25 mg/kg/day divided every 12 hours or 20 mg/kg/day divided every 8 hours 1
  • Severe infections: 45 mg/kg/day divided every 12 hours or 40 mg/kg/day divided every 8 hours 1

• For infants <12 weeks (3 months): Maximum dose of 30 mg/kg/day divided every 12 hours due to incompletely developed renal function 1

Dosing in Renal Impairment

• For patients with GFR 10-30 mL/min: 500 mg or 250 mg every 12 hours, depending on infection severity 1
• For patients with GFR <10 mL/min: 500 mg or 250 mg every 24 hours, depending on infection severity 1
• For hemodialysis patients: 500 mg or 250 mg every 24 hours with additional doses both during and at the end of dialysis 1
• Patients with severe renal impairment (GFR <30 mL/min) should NOT receive the 875 mg dose 1

Clinical Efficacy

• Augmentin has demonstrated success rates of approximately 70-85% for treating UTIs, including those caused by amoxicillin-resistant organisms 2, 3
• In elderly patients with UTIs, Augmentin has shown significantly higher efficacy (87.5%) compared to amoxicillin alone (43%) 4
• For recurrent UTIs, Augmentin has demonstrated microbiological cure rates of 84% one week after treatment and 67% one month later 3

Special Considerations

• For complicated UTIs, the higher dose regimen (875 mg every 12 hours or 500 mg every 8 hours) is recommended 1, 3
• For multidrug-resistant organisms, alternative agents may be needed based on susceptibility testing 5
• Augmentin is particularly valuable for treating UTIs caused by beta-lactamase-producing bacteria that would otherwise be resistant to amoxicillin alone 2, 4

Common Pitfalls and Caveats

• Always take Augmentin with food to minimize gastrointestinal side effects 1
• Complete the full course of therapy even if symptoms improve before completion 1
• Side effects occur in approximately 20% of patients but are generally mild and rarely require discontinuation of treatment 3
• For patients with penicillin allergies, alternative agents should be considered 5
• Resistance patterns vary geographically; consider local resistance patterns when selecting empiric therapy 5