What is the recommended dose and frequency of Augmentin (amoxicillin/clavulanate) for urinary tract infections (UTIs) and pneumonia?

Recommended Augmentin Dosing for UTI and Pneumonia

For urinary tract infections and pneumonia, Augmentin (amoxicillin/clavulanate) should be dosed at 875 mg/125 mg every 12 hours for adults, which provides comparable efficacy to the 500 mg/125 mg every 8 hours regimen with fewer severe diarrhea episodes. 1

Urinary Tract Infections (UTIs)

Uncomplicated UTIs

• For uncomplicated UTIs, Augmentin 875 mg/125 mg every 12 hours for 3-7 days is recommended 1
• Alternative regimen: 500 mg/125 mg every 8 hours for 3-7 days 1
• Clinical trials have shown success rates of approximately 70% for amoxicillin-resistant organisms when using Augmentin 2
• In elderly patients, Augmentin showed significantly better response rates (87.5%) compared to amoxicillin alone (43%) 3

Complicated UTIs

• For complicated UTIs (including pyelonephritis or abnormalities of the urinary tract):
  • Augmentin 875 mg/125 mg every 12 hours for 5-7 days 1
  • Alternative regimen: 500 mg/125 mg every 8 hours for 5-7 days 1
  • Clinical studies showed comparable bacteriological success rates between the two dosing regimens (81% for q12h vs 80% for q8h at 2-4 days post-therapy) 1

Pneumonia

Community-Acquired Pneumonia

• Augmentin 875 mg/125 mg every 12 hours for 7-14 days 1
• Alternative regimen: 500 mg/125 mg every 8 hours for 7-14 days 1

Hospital-Acquired Pneumonia

• For more severe infections, higher doses may be required, though standard dosing remains 875 mg/125 mg every 12 hours 1
• Duration typically 10-14 days based on clinical response 1

Pediatric Dosing

• Pediatric dosing should be based on the amoxicillin component:
  • For less severe infections: 25-45 mg/kg/day divided into two doses every 12 hours
  • For more severe infections: 45-90 mg/kg/day divided into two doses every 12 hours

Important Clinical Considerations

Advantages of 875 mg q12h over 500 mg q8h

• Comparable efficacy between the two regimens 1
• Significantly lower rates of severe diarrhea (1.0% vs 2.5%) 1
• Better patient compliance with twice-daily dosing 1

Side Effects and Monitoring

• Most common adverse effect is diarrhea (approximately 15% of patients) 1
• Gastrointestinal side effects are generally mild and rarely require discontinuation of treatment 4
• Taking Augmentin with food can help minimize gastrointestinal side effects 5

Special Populations

• In patients with recurrent UTIs, Augmentin has shown microbiological cure rates of 84% at 1 week and 67% at 1 month post-treatment 4
• For elderly patients with UTIs, Augmentin has demonstrated superior efficacy compared to amoxicillin alone 3

Resistance Considerations

• Augmentin is particularly valuable for treating infections caused by beta-lactamase-producing organisms that would otherwise be resistant to amoxicillin alone 2
• The addition of clavulanic acid significantly reduces resistance levels in most Gram-negative urinary pathogens 2

Remember that dosing may need to be adjusted in patients with severe renal impairment (creatinine clearance <30 mL/min).