What is the recommended dosage of Augmentin (amoxicillin/clavulanate) IV for adults with bacterial infections?

Augmentin IV Dosage for Adults with Bacterial Infections

For adults with bacterial infections, the recommended IV dosage of Augmentin (amoxicillin/clavulanate) is 1.2 g (1000 mg amoxicillin/200 mg clavulanate) every 6-8 hours for most infections, with more severe infections requiring doses up to 1.2 g every 4-6 hours. 1

Dosing Guidelines Based on Infection Type

Standard Dosing

• For most bacterial infections in adults, Augmentin IV should be administered at 1.2 g every 6-8 hours 1
• For more severe infections, particularly respiratory tract infections, the dose should be increased to 1.2 g every 4-6 hours 1

Specific Infection Types

• Skin and Soft Tissue Infections (SSTI):

  • For methicillin-susceptible Staphylococcus aureus (MSSA) infections: 1.2 g IV every 6-8 hours 2
  • For complicated SSTI: 1.2 g IV every 6-8 hours for 7-14 days depending on clinical response 2

• Respiratory Tract Infections:

  • Community-acquired pneumonia: 1.2 g IV every 6-8 hours 3
  • More severe respiratory infections may require 1.2 g every 4-6 hours 1

• Intra-abdominal Infections:

  • 1.2 g IV every 6-8 hours, with duration based on clinical response 1

Special Population Considerations

Renal Impairment

• For patients with creatinine clearance 10-30 mL/min: 1.2 g IV initially, then 600 mg IV every 12 hours 1
• For patients with creatinine clearance <10 mL/min: 1.2 g IV initially, then 600 mg IV every 24 hours 1
• Hemodialysis patients should receive an additional dose during and at the end of dialysis 1

Hepatic Impairment

• No specific dose adjustment is required for hepatic impairment alone 1
• Monitor liver function tests in patients with evidence of hepatic dysfunction 1

Duration of Therapy

• Uncomplicated infections: 7-10 days 2
• Complicated infections: 14-21 days, depending on clinical response 2
• Bacteremia or endocarditis:
  • Uncomplicated bacteremia: minimum 14 days 2
  • Complicated bacteremia: 4-6 weeks 2
  • Infective endocarditis: 6 weeks 2

Administration Guidelines

• Administer by slow intravenous injection over 3-4 minutes or by intravenous infusion over 30-40 minutes 1
• For infusion, dilute in appropriate IV solution (typically 0.9% sodium chloride or 5% dextrose) 1
• Reconstituted solution should be used within 4 hours if stored at room temperature 1

Common Pitfalls and Caveats

• Do not confuse IV and oral dosing: IV Augmentin has different dosing than oral formulations 1
• Monitor for hypersensitivity reactions: Patients with a history of penicillin allergy may experience cross-reactivity 1
• Assess renal function: Dosage adjustment is necessary in patients with renal impairment 1
• Superinfection risk: Prolonged use may result in overgrowth of non-susceptible organisms 1
• C. difficile-associated diarrhea: Monitor for diarrhea during and after treatment 2
• Transition to oral therapy: Consider switching to oral Augmentin when clinically appropriate to reduce IV-related complications 3

Augmentin IV remains a valuable broad-spectrum antibiotic for treating various bacterial infections, particularly when oral therapy is not appropriate or when treating more severe infections requiring higher tissue concentrations of the antibiotic.