Recommended Doses of Augmentin (Amoxicillin-Clavulanic Acid) for UTIs
For urinary tract infections (UTIs), Augmentin (amoxicillin-clavulanic acid) should be dosed at 375 mg three times daily for 7 days in uncomplicated cases, and for 7-14 days in complicated UTIs. 1
Dosing Recommendations Based on UTI Classification
Uncomplicated UTIs
- 375 mg three times daily (250 mg amoxicillin plus 125 mg clavulanic acid per tablet) for 7 days 2
- Microbiological cure rates of approximately 84% one week after treatment completion 2
Complicated UTIs
- 375 mg three times daily for 7-14 days 3
- Longer duration (10-14 days) recommended for patients with delayed response 3
- All male UTIs are considered complicated and require the longer treatment duration 4
Recurrent UTIs
- Initial treatment: 375 mg three times daily for 7 days 2
- Microbiological cure rates of 67% at one month post-treatment 2
- Consider prophylactic regimens for frequent recurrences 3
Special Populations
Pediatric Dosing
- Initial treatment: 40 mg/kg/day divided into two doses for 5 days 5
- For recurrent UTIs: After initial treatment, 20 mg/kg once daily (evening dose) for prophylaxis 6, 5
- Pediatric formulations should be used for appropriate weight-based dosing 5
Renal Impairment
- Dose adjustment required based on creatinine clearance 3
- For patients with severe renal impairment (creatinine clearance <10 mL/min), consider alternative agents or reduced dosing frequency 3
Clinical Considerations
Duration of Therapy
- 7 days is recommended for patients with prompt symptom resolution 3
- 10-14 days for patients with delayed response 3
- Catheter-associated UTIs typically require the full 7-14 day course regardless of catheter removal 3
Antimicrobial Resistance Considerations
- Augmentin is particularly valuable for treating UTIs caused by amoxicillin-resistant organisms 1
- The addition of clavulanic acid reduces resistance in most Gram-negative urinary pathogens 1
- Success rates of approximately 70% have been reported for amoxicillin-resistant organisms 1
Alternative Regimens When Augmentin Is Not Appropriate
- For multidrug-resistant organisms, consider newer agents like ceftazidime-avibactam, meropenem-vaborbactam, or imipenem-cilastatin-relebactam 3
- Fluoroquinolones (if local resistance is low) or trimethoprim-sulfamethoxazole may be alternatives 4
- Single-dose aminoglycoside therapy may be considered for simple cystitis due to resistant organisms 3
Monitoring and Follow-up
- Obtain urine culture before initiating therapy 4
- Monitor for common side effects, which occur in approximately 20% of patients but are generally mild 2
- Gastrointestinal side effects can be minimized by taking medication with food 5
- Consider follow-up cultures after completion of therapy to confirm eradication in complicated cases 4
Common Pitfalls and Caveats
- Failure of therapy may indicate underlying anatomical abnormalities requiring further investigation 7
- Taking medication with food can reduce gastrointestinal side effects without significantly affecting efficacy 2
- For patients experiencing vomiting with twice-daily dosing, consider switching to three times daily dosing at a lower individual dose 5
- Always verify local resistance patterns before empiric therapy, as resistance rates to amoxicillin-clavulanate vary by region 3