Augmentin's Effectiveness Against Staphylococcus saprophyticus
Augmentin (amoxicillin-clavulanate) is effective against Staphylococcus saprophyticus infections, as it is specifically listed in the FDA drug label as one of the organisms susceptible to this antibiotic combination. 1
Mechanism and Coverage
- Augmentin combines amoxicillin (a semisynthetic antibiotic with bactericidal activity against Gram-positive and Gram-negative bacteria) with clavulanic acid (a beta-lactamase inhibitor) 1
- Clavulanic acid protects amoxicillin from degradation by beta-lactamase enzymes, extending its spectrum to include many bacteria normally resistant to amoxicillin alone 1
- The FDA drug label specifically lists Staphylococcus saprophyticus among the organisms for which in vitro data shows susceptibility to amoxicillin/clavulanic acid 1
Clinical Application for S. saprophyticus Infections
- S. saprophyticus is a common cause of urinary tract infections (UTIs), particularly in young, sexually active women 2, 3
- Augmentin has demonstrated effectiveness in treating urinary tract infections with a success rate of about 70% for amoxicillin-resistant organisms 2
- The standard dosage of Augmentin (375 mg three times daily) achieves adequate urinary levels of amoxicillin potentiated by clavulanic acid to treat most Gram-negative urinary pathogens 2
Alternative Treatment Options
For patients who cannot tolerate Augmentin or have resistant infections:
- Trimethoprim-sulfamethoxazole (TMP-SMX) 160/800 mg twice daily is an effective alternative for S. saprophyticus infections 4
- Doxycycline 100 mg twice daily can be considered for skin and soft tissue infections involving staphylococci 5
- For more severe infections, vancomycin 15-20 mg/kg IV every 8-12 hours may be used 6, 4
Important Considerations and Caveats
- Recent research has raised concerns about the adequacy of empirical antibiotic treatments for UTIs caused by S. saprophyticus, with up to 60% of cystitis cases receiving inappropriate initial therapy 7
- When treating S. saprophyticus infections, it's important to confirm susceptibility through culture and sensitivity testing 7
- Augmentin is well-tolerated but may cause gastrointestinal side effects including diarrhea and abdominal pain in some patients 8
- For complicated infections or pyelonephritis caused by S. saprophyticus, consider initial parenteral therapy before transitioning to oral Augmentin 6
Dosing Recommendations
- For uncomplicated UTIs: Augmentin 500/125 mg orally twice daily or 250/125 mg orally three times daily for 5-7 days 1, 2
- For complicated UTIs: Augmentin 875/125 mg orally twice daily for 10-14 days 1, 9
- For skin and soft tissue infections: Augmentin 875/125 mg orally twice daily for 7-10 days 6
In conclusion, Augmentin is an appropriate choice for treating S. saprophyticus infections, particularly urinary tract infections, due to its specific activity against this organism as confirmed by the FDA drug label and supporting clinical evidence.