What is the recommended dosing for Augmentin (amoxicillin-clavulanate) for the treatment of a sinus infection?

Augmentin Dosing for Sinus Infection

For adults with sinus infection, the recommended dose of Augmentin (amoxicillin-clavulanate) is 875/125 mg twice daily for 10-14 days. 1, 2

First-Line Treatment Approach

• Amoxicillin is typically the first-line antibiotic for uncomplicated sinusitis 1, 3
• For patients who fail to improve after 3-5 days of amoxicillin therapy, switching to Augmentin (amoxicillin-clavulanate) is recommended 1

Specific Augmentin Dosing Recommendations

• Standard adult dose: 875/125 mg twice daily for 10-14 days 1, 2
• Alternative dosing: 500/125 mg three times daily for 10-14 days 3, 4
• For suspected resistant organisms or treatment failure: high-dose regimen of 90 mg/kg amoxicillin component (not to exceed 2 g every 12 hours) 1

Treatment Duration

• Standard treatment course is 10-14 days 1, 2, 3
• Treatment should continue until the patient has been symptom-free for 7 days 1, 3

When to Use Augmentin vs. Amoxicillin

• Use Augmentin in scenarios such as:
  • Moderate to severe illness 2
  • Recent antibiotic use (within 4-6 weeks) 2
  • Treatment failure with amoxicillin 1
  • Areas with high prevalence of β-lactamase-producing H. influenzae 2
  • Regions with high incidence of antibiotic resistance 1

Treatment Response Assessment

• Evaluate response after 72 hours of treatment 2
• If no improvement or worsening after 72 hours, consider switching to an alternative antibiotic or reevaluating the diagnosis 2
• Patients with a partial response should continue antibiotics for the full course 1

Common Pitfalls to Avoid

• Treating viral sinusitis with antibiotics is inappropriate and contributes to antibiotic resistance 2, 3
• Not completing the full course of antibiotics can lead to incomplete eradication and potential relapse 2
• Using standard-dose amoxicillin in areas with high resistance patterns may lead to treatment failure 2

Alternative Options for Penicillin-Allergic Patients

• For patients allergic to or intolerant of amoxicillin-clavulanate, alternatives include:
  • Cephalosporins (if no history of anaphylaxis to penicillin) 1, 2
  • Macrolides (e.g., clarithromycin) 5
  • Doxycycline 2
  • Respiratory fluoroquinolones (for severe cases or treatment failures) 1

Evidence on Comparative Efficacy

• Recent research found no significant benefit of high-dose amoxicillin-clavulanate compared to standard-dose in adults with acute sinusitis 6
• Some studies suggest that nasal corticosteroids may be beneficial when added to antibiotic therapy for symptom relief in post-viral sinusitis 7