From the Guidelines
Augmentin (amoxicillin-clavulanate) is an appropriate choice for treating uncomplicated catheter-associated urinary tract infection, but it should be used with caution due to its inferior efficacy and more adverse effects compared to other UTI antimicrobials. According to the 2011 guidelines by the Infectious Diseases Society of America and the European Society for Micrology and Infectious Diseases 1, beta-lactam agents, including amoxicillin-clavulanate, can be used for therapy when other recommended agents cannot be used. The guidelines recommend a 3-7 day regimen for beta-lactam agents, but the specific dosage for Augmentin is not specified.
Some key points to consider when using Augmentin for uncomplicated catheter-associated urinary tract infection include:
- The efficacy of Augmentin may be inferior to other UTI antimicrobials, such as nitrofurantoin monohydrate/macrocrystals or trimethoprim-sulfamethoxazole 1
- Augmentin has a higher propensity for adverse effects compared to other UTI antimicrobials 1
- The use of Augmentin should be guided by local resistance rates and the susceptibility of the infecting strain 1
- Proper catheter care, including regular cleaning and changing of dressings, is essential alongside antibiotic therapy to prevent the spread of infection and promote healing.
It is also important to note that other antibiotics, such as nitrofurantoin monohydrate/macrocrystals or trimethoprim-sulfamethoxazole, may be more effective and have fewer adverse effects than Augmentin for uncomplicated catheter-associated urinary tract infection 1. Therefore, the use of Augmentin should be reserved for cases where other recommended agents cannot be used, and its use should be guided by local resistance rates and the susceptibility of the infecting strain.
From the FDA Drug Label
1.5 Urinary Tract Infections – caused by beta-lactamase–producing isolates of E. coli, Klebsiella species, and Enterobacter species. The FDA drug label does indicate that amoxicillin-clavulanate can be used to treat urinary tract infections caused by certain bacteria, including E. coli, Klebsiella species, and Enterobacter species.
- The label does not specify catheter-associated urinary tract infections, but it does mention urinary tract infections in general.
- Uncomplicated catheter-associated urinary tract infections may be treated with amoxicillin-clavulanate if the causative bacteria are susceptible, but this is not directly stated in the label. However, based on the information provided, it can be inferred that amoxicillin-clavulanate may be used to treat uncomplicated catheter-associated urinary tract infections, but only if the infection is caused by susceptible bacteria, such as beta-lactamase–producing isolates of E. coli, Klebsiella species, and Enterobacter species 2.
From the Research
Treatment of Uncomplicated Catheter-Associated Urinary Tract Infection
- The effectiveness of Augmentin (amoxicillin-clavulanate) in treating uncomplicated catheter-associated urinary tract infections is discussed in several studies 3, 4, 5.
- According to a study published in 2020, amoxicillin-clavulanate is listed as a second-line option for the treatment of urinary tract infections, including those caused by extended-spectrum β-lactamases (ESBLs)-producing Enterobacteriales 3.
- Another study from 2020 discusses the importance of guideline-based treatment of urinary tract infections, emphasizing the need for adequate antibiotic therapy based on the stratification into complicated and uncomplicated infections, as well as upper and lower infections 5.
- A 2014 review on the prevention and treatment of catheter-associated urinary tract infections highlights the importance of evidence-based catheter management and the use of empirical antibiotic treatment with activity against multiresistant uropathogens in cases of serious catheter-associated UTI 4.
- However, the studies do not provide direct evidence on the effectiveness of Augmentin in treating uncomplicated catheter-associated urinary tract infections specifically.
Pathophysiology and Treatment of Catheter-Associated Urinary Tract Infection
- A 2019 review on the pathophysiology, treatment, and prevention of catheter-associated urinary tract infection emphasizes the differences between uncomplicated UTI and catheter-associated UTI in clinical manifestations, causative organisms, and pathophysiology 6.
- The review highlights the importance of understanding the key aspects of each condition to develop successful treatment options and improve patient outcomes.
- A study from 1994 discusses the diagnosis and management of peritoneal dialysis catheter exit-site and tunnel infections, but does not provide relevant information on the treatment of uncomplicated catheter-associated urinary tract infections 7.