What is the recommended dose of Augmentin (amoxicillin/clavulanate) for treating infections?

Augmentin (Amoxicillin/Clavulanate) Dosing Recommendations

For treating infections, Augmentin (amoxicillin/clavulanate) should be dosed according to the severity of infection, patient age, weight, and renal function, with 875/125 mg twice daily or 500/125 mg three times daily being the standard adult dosing for most moderate to severe infections.

Adult Dosing

Standard Dosing

• For mild to moderate infections (ear, nose, throat, skin, genitourinary tract): 500 mg every 12 hours or 250 mg every 8 hours 1
• For severe infections (ear, nose, throat, skin, genitourinary tract): 875 mg every 12 hours or 500 mg every 8 hours 1
• For lower respiratory tract infections (mild, moderate, or severe): 875 mg every 12 hours or 500 mg every 8 hours 1

Special Situations

• For chronic carriers of Group A Streptococcus: Amoxicillin/clavulanate 40 mg amoxicillin per kg per day in three doses (maximum = 2,000 mg amoxicillin per day) for 10 days 2
• For intra-abdominal infections in non-critically ill and immunocompetent patients with adequate source control: Amoxicillin/Clavulanate 2 g/0.2 g every 8 hours 2
• For intra-abdominal infections in critically ill or immunocompromised patients: Piperacillin/tazobactam 6 g/0.75 g loading dose then 4 g/0.5 g every 6 hours or 16 g/2 g by continuous infusion 2
• For finger lacerations from wood chippers: Amoxicillin-clavulanate (875/125 mg twice daily) 3

Pediatric Dosing

Based on Age and Weight

• For children ≥3 months and <40 kg with mild/moderate infections: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours 1
• For children ≥3 months and <40 kg with severe infections: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours 1
• For children <12 weeks (3 months): Maximum dose of 30 mg/kg/day divided every 12 hours due to incompletely developed renal function 1

Duration of Treatment

• Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained 1
• For Streptococcus pyogenes infections: At least 10 days of treatment to prevent acute rheumatic fever 1
• For intra-abdominal infections: 4 days in immunocompetent and non-critically ill patients if source control is adequate; up to 7 days in immunocompromised or critically ill patients 2

Renal Dosing Adjustments

• GFR 10-30 mL/min: 500 mg or 250 mg every 12 hours, depending on the severity of infection 1
• GFR <10 mL/min: 500 mg or 250 mg every 24 hours, depending on severity of infection 1
• Hemodialysis: 500 mg or 250 mg every 24 hours, plus an additional dose both during and at the end of dialysis 1
• Patients with GFR <30 mL/min should NOT receive the 875 mg dose 1

Administration Guidelines

• Take at the start of a meal to minimize gastrointestinal intolerance 1
• For oral suspension, reconstitute according to package instructions and shake well before using 1
• Any unused portion of reconstituted suspension must be discarded after 14 days 1

Common Pitfalls and Caveats

• Inadequate dosing for severe infections can lead to treatment failure and antimicrobial resistance 2
• Failure to adjust dosing in renal impairment can lead to toxicity 1
• Not completing the full course of therapy, especially for streptococcal infections, can lead to complications like rheumatic fever 1
• For urinary tract infections, Augmentin has shown success rates of about 70% for amoxicillin-resistant organisms when dosed at 375 mg three times daily 4