What is the recommended dosage of Augmentin (amoxicillin-clavulanate) for treating pneumonia in adults?

Augmentin Dosage for Pneumonia in Adults

For adults with pneumonia requiring Augmentin (amoxicillin-clavulanate), the recommended dosage is 875 mg/125 mg twice daily or 500 mg/125 mg three times daily for more severe respiratory tract infections. 1

Dosage Recommendations Based on Patient Characteristics

Healthy Outpatients Without Comorbidities

• For healthy outpatients without comorbidities, amoxicillin 1 g three times daily is the preferred first-line therapy (not Augmentin) 2
• Doxycycline 100 mg twice daily or macrolides are alternatives in this population 2

Outpatients With Comorbidities

• For outpatients with comorbidities (chronic heart, lung, liver, or renal disease; diabetes mellitus; alcoholism; malignancy; or asplenia), Augmentin is recommended as part of combination therapy 2
• Dosage options include:
  • 500 mg/125 mg three times daily, OR
  • 875 mg/125 mg twice daily, OR
  • 2,000 mg/125 mg twice daily 2
• Augmentin should be combined with a macrolide (azithromycin or clarithromycin) or doxycycline 2

Administration Considerations

• Augmentin should be taken at the start of a meal to minimize gastrointestinal intolerance and enhance absorption of clavulanate potassium 1
• For patients with difficulty swallowing tablets, appropriate suspension formulations are available 1

Treatment Duration

• Treatment duration of 7 days or less has been shown to be effective for mild to moderate community-acquired pneumonia 3
• This shorter duration may help limit antimicrobial resistance, decrease cost, and improve patient adherence 3

Clinical Efficacy and Rationale

• Augmentin provides broad-spectrum antibacterial activity with coverage of beta-lactamase-producing pathogens commonly found in respiratory infections 4
• The combination has maintained high clinical efficacy in respiratory tract infections for over 20 years despite increasing antimicrobial resistance 4
• Early studies demonstrated good clinical response in patients with lower respiratory tract infections treated with Augmentin 5, 6

Common Pitfalls to Avoid

• Do not substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet, as they contain the same amount of clavulanic acid (125 mg) but different amounts of amoxicillin 1
• Do not use macrolide monotherapy in areas with high pneumococcal resistance to macrolides (≥25%) 2
• Avoid underestimating pneumonia severity, which can lead to inappropriate treatment intensity 7
• For patients not improving on initial therapy, consider adding or changing antibiotics 7

Special Considerations

• For patients with recent exposure to antibiotics within the previous 3 months, select an alternative from a different class 2, 7
• For hospitalized patients with severe pneumonia, parenteral therapy with a β-lactam plus macrolide is generally recommended rather than oral therapy 7, 8