What is the recommended adult dose of Augmentin (amoxicillin-clavulanate)?

Recommended Adult Dosage of Augmentin (Amoxicillin-Clavulanate)

The standard adult dosage of Augmentin is 875 mg amoxicillin/125 mg clavulanate taken twice daily, or 500 mg amoxicillin/125 mg clavulanate taken three times daily, depending on the severity and type of infection. 1

Standard Dosing Regimens

• For mild to moderate infections: 500 mg every 12 hours or 250 mg every 8 hours 2
• For severe infections: 875 mg every 12 hours or 500 mg every 8 hours 2
• For lower respiratory tract infections (mild, moderate, or severe): 875 mg every 12 hours or 500 mg every 8 hours 2

Specific Clinical Scenarios

• For treatment of Group A streptococcal carriers: 40 mg/kg/day of amoxicillin component in three equally divided doses for 10 days 3
• For H. pylori infection: 1 gram amoxicillin with 500 mg clarithromycin and 30 mg lansoprazole, all given twice daily for 14 days (triple therapy) 2
• For community-acquired respiratory tract infections: 875 mg/125 mg twice daily is the standard regimen 4

Dosage Adjustments for Special Populations

• For patients with renal impairment:
  • GFR 10-30 mL/min: 500 mg or 250 mg every 12 hours, depending on infection severity 2
  • GFR less than 10 mL/min: 500 mg or 250 mg every 24 hours, depending on infection severity 2
  • Hemodialysis patients: 500 mg or 250 mg every 24 hours plus an additional dose during and at the end of dialysis 2
• Patients with severe renal impairment (GFR less than 30 mL/min) should NOT receive the 875 mg dose 2

Administration Guidelines

• Augmentin should be taken at the start of a meal to minimize gastrointestinal intolerance 2
• Treatment should generally continue for a minimum of 48 to 72 hours beyond symptom resolution 2
• For Streptococcus pyogenes infections, a minimum of 10 days of treatment is recommended to prevent acute rheumatic fever 2

Common Pitfalls and Considerations

• The 875 mg formulation should not be used in patients with severe renal impairment (GFR <30 mL/min) 2
• Completing the full course of therapy is crucial to prevent treatment failure and resistance development 1
• For patients who have received antibiotics in the previous 4-6 weeks, high-dose formulations may be particularly important to overcome potential resistant organisms 5
• Monitor for common adverse effects including diarrhea, nausea, and skin rash 4

By following these dosing guidelines, clinicians can optimize the efficacy of Augmentin while minimizing the risk of adverse effects and antimicrobial resistance.