What should I do if I develop diarrhea after taking Augmentin (amoxicillin/clavulanate)?

Management of Diarrhea After Taking Augmentin (Amoxicillin/Clavulanate)

If you've developed diarrhea after taking Augmentin, you should discontinue the medication and contact your healthcare provider, as this is a common side effect that may require medical attention, especially if severe or persistent. 1

Understanding Antibiotic-Associated Diarrhea

• Diarrhea is a common problem caused by antibiotics like Augmentin and typically resolves when the antibiotic is discontinued 1
• Augmentin (amoxicillin/clavulanate) has been associated with gastrointestinal side effects, including diarrhea, which can range from mild to severe 2, 3
• In clinical studies, the incidence of diarrhea with traditional Augmentin formulations has been reported to be as high as 26.7% 3

Assessment of Severity

Evaluate your diarrhea based on these factors:

• Mild diarrhea (uncomplicated): Slight increase in stool frequency without other symptoms 4
• Moderate to severe diarrhea (complicated): Characterized by:
  • Frequent watery stools (more than 4-6 per day above baseline)
  • Presence of blood or mucus in stool
  • Accompanying fever, severe abdominal cramping, or dehydration
  • Symptoms persisting for more than 2-3 days 1, 4

Management Approach

For Mild Diarrhea:

1. Discontinue Augmentin if possible (consult with your healthcare provider) 1
2. Maintain hydration with clear liquids (8-10 large glasses daily) 4
3. Dietary modifications:
   • Eliminate lactose-containing products
   • Avoid alcohol and high-osmolar supplements
   • Eat small, frequent meals of bland foods (bananas, rice, applesauce, toast, plain pasta) 4
4. Consider loperamide (anti-diarrheal medication):
   • Initial dose of 4 mg followed by 2 mg after every loose stool
   • Do not exceed 16 mg per day
   • Discontinue after being diarrhea-free for 12 hours 4

For Moderate to Severe Diarrhea:

1. Seek immediate medical attention if you experience:

   • Severe diarrhea lasting more than 2-3 days
   • Watery or bloody stools with abdominal cramps and fever
   • Signs of dehydration (dizziness upon standing, decreased urination)
   • High fever or severe abdominal pain 1, 4

2. Medical evaluation may include:

   • Stool examination for blood and infectious agents
   • Blood tests to check for infection and electrolyte imbalances
   • Assessment for dehydration 4

3. Treatment may involve:

   • Intravenous fluids for dehydration
   • Possible hospitalization for severe cases
   • Testing for Clostridioides difficile (C. diff) infection, which can occur even 2 months after antibiotic use 1

Special Considerations

• Clostridioides difficile infection: Antibiotics can disrupt normal gut flora, allowing overgrowth of C. difficile bacteria, which can cause severe, potentially life-threatening diarrhea 1
• Alternative antibiotics: If you need to continue antibiotic therapy, your healthcare provider may switch you to an alternative with lower risk of gastrointestinal side effects 3
• Probiotics: While not mentioned in the provided guidelines, some clinicians may recommend probiotics to help restore normal gut flora

When to Resume Normal Diet

• Gradually add solid foods back to your diet as diarrhea resolves 4
• Continue dietary modifications until bowel movements return to normal 4

Prevention for Future Antibiotic Courses

• Taking Augmentin with meals or snacks may reduce gastrointestinal upset 1
• Newer formulations of Augmentin with modified dosing schedules may have lower rates of diarrhea (9.6% vs 26.7%) 3
• Complete the full course of any prescribed antibiotics unless instructed otherwise by your healthcare provider 1