What is the typical frequency and length of treatment for amoxicillin-clavulanate (Augmentin) 875 mg?

Amoxicillin-Clavulanate 875 mg Dosing and Treatment Duration

For adults, amoxicillin-clavulanate 875/125 mg should be administered twice daily (every 12 hours) for 10-14 days for most respiratory infections, including sinusitis. 1, 2

Standard Dosing Regimen

• The standard adult dose of amoxicillin-clavulanate 875/125 mg is twice daily (every 12 hours) for 10-14 days 1, 2
• This twice-daily regimen has been shown to be as effective as the older three-times-daily regimen (500/125 mg every 8 hours) 3, 4
• FDA clinical trials demonstrated comparable efficacy between the 875/125 mg every 12 hours and 500/125 mg every 8 hours dosing regimens 3

Treatment Duration

• For respiratory tract infections, including sinusitis, the standard treatment duration is 10-14 days 1, 2
• Treatment should continue until the patient has been symptom-free for 7 days 1
• For uncomplicated urinary tract infections, a shorter duration of 3-7 days may be appropriate 5

Efficacy Evidence

• Clinical trials have demonstrated that the twice-daily regimen (875/125 mg) provides similar clinical success rates compared to the three-times-daily regimen (500/125 mg) 4, 6
• In a study of patients with acute bacterial maxillary sinusitis, clinical success rates were 93% for the every 12-hour regimen and 88% for the every 8-hour regimen 4
• For lower respiratory tract infections, clinical success rates were 93% and 94% for the 12-hour and 8-hour regimens, respectively 6

Advantages of Twice-Daily Dosing

• The twice-daily regimen offers improved patient convenience and potentially better adherence 3
• The 875/125 mg twice-daily regimen has shown a lower incidence of severe diarrhea compared to the 500/125 mg three-times-daily regimen (1% vs 2%) 3
• In pediatric studies, the twice-daily regimen resulted in significantly lower rates of diarrhea compared to three-times-daily dosing (14% vs 34%) 3

Special Considerations

• For suspected resistant organisms or treatment failure with standard amoxicillin, high-dose amoxicillin-clavulanate may be considered 1, 2
• In regions with high prevalence of penicillin-resistant S. pneumoniae, higher doses may be necessary 5
• For patients with recent antibiotic use, contact with healthcare environments, or prior antibiotic therapy failure, higher doses may be warranted 5

Treatment Response Assessment

• Clinical response should be evaluated after 72 hours of treatment 1
• If no improvement or worsening is observed, consider switching to an alternative antibiotic or reevaluating the diagnosis 1
• Patients with a partial response should complete the full course of antibiotics 1, 2

Common Pitfalls

• Treating viral infections with antibiotics is inappropriate and contributes to antibiotic resistance 1
• Not completing the full course of antibiotics can lead to incomplete eradication and potential relapse 1
• Using standard-dose amoxicillin-clavulanate when high-dose therapy is indicated (e.g., in areas with high resistance rates) may lead to treatment failure 1, 5

The twice-daily 875/125 mg dosing regimen offers equivalent efficacy with improved convenience and potentially better tolerability compared to the three-times-daily regimen, making it the preferred choice for most adult patients requiring amoxicillin-clavulanate therapy.