Recommended Dosage of Augmentin for UTI
For urinary tract infections (UTIs), the recommended dosage of Augmentin (amoxicillin/clavulanate) is 875 mg/125 mg every 12 hours or 500 mg/125 mg every 8 hours for 7-14 days. 1
Dosing Options and Clinical Evidence
- FDA clinical studies have demonstrated comparable efficacy between the 875 mg/125 mg every 12 hours and 500 mg/125 mg every 8 hours dosing regimens for complicated UTIs 1
- The twice-daily (every 12 hours) regimen showed similar bacteriological success rates to the three-times-daily (every 8 hours) regimen in clinical trials 1
- The twice-daily regimen had a lower incidence of severe diarrhea (1% vs 2%) compared to the three-times-daily regimen, which may improve patient adherence 1
Treatment Duration Considerations
- For uncomplicated UTIs in women, a 7-day course is typically sufficient 2
- For complicated UTIs, including those in men, elderly patients, or patients with underlying urological abnormalities, a longer duration of 7-14 days is recommended 3, 4
- All male UTIs are considered complicated UTIs according to guidelines, requiring the longer treatment duration 3
Special Populations and Considerations
- For patients with recurrent UTIs, Augmentin has shown microbiological cure rates of 84% one week after treatment and 67% one month later 2
- For complicated UTIs in patients with abnormalities of the urinary tract, the bacteriological success rates were 81% at 2-4 days post-therapy and declined to 52-55% at 2-4 weeks post-therapy 1
- In patients with multidrug-resistant organisms, alternative agents may be needed based on susceptibility testing 5
Side Effects and Tolerability
- The most common adverse effect is diarrhea, occurring in approximately 14-15% of patients 1
- The twice-daily regimen (875 mg/125 mg) has a statistically significant lower rate of severe diarrhea compared to the three-times-daily regimen (500 mg/125 mg) 1
- Other side effects are generally mild and rarely require discontinuation of treatment 2
Alternative Regimens When Augmentin Is Not Appropriate
- For multidrug-resistant organisms, consider ceftazidime-avibactam 2.5 g IV q8h for complicated UTIs caused by carbapenem-resistant Enterobacteriaceae (CRE) 6
- Meropenem-vaborbactam 4 g IV q8h or imipenem-cilastatin-relebactam 1.25 g IV q6h are alternatives for complicated UTIs caused by CRE 6
- For patients with penicillin allergies, alternative agents should be considered based on local resistance patterns 5