Augmentin Dosage for Skin Infections
For uncomplicated skin and soft tissue infections in adults, use Augmentin 875 mg/125 mg orally twice daily or 500 mg/125 mg three times daily for 7-10 days, with treatment duration based on clinical response.
Adult Dosing Recommendations
- Standard oral dosing is 875 mg/125 mg twice daily or 500 mg/125 mg three times daily for 7-10 days 1
- For severe or complicated skin infections requiring intravenous therapy, use 1.2 g IV every 6-8 hours 1
- Treatment duration should be 7 days for uncomplicated infections and 10-14 days for complicated infections, adjusted based on clinical improvement 2
Pediatric Dosing
- For children, dose based on the amoxicillin component at 25-50 mg/kg/day divided into appropriate intervals 3
- High-dose formulation (90 mg/kg/day of amoxicillin component) is available for resistant pathogens, though this is primarily studied in respiratory infections 4
Clinical Decision-Making Algorithm
Step 1: Assess infection severity and likely pathogens
- For mild-to-moderate cellulitis or simple abscesses with suspected methicillin-susceptible Staphylococcus aureus (MSSA) or Streptococcus species, Augmentin is appropriate 3
- If MRSA is suspected or confirmed, Augmentin is ineffective and alternative agents like clindamycin (300-450 mg every 6-8 hours) should be used instead 3, 2
Step 2: Choose route of administration
- Oral therapy is suitable for outpatient management of uncomplicated infections 1
- IV therapy (1.2 g every 6-8 hours) is reserved for hospitalized patients with complicated infections, severe cellulitis, or inability to tolerate oral medications 1
Step 3: Monitor response
- Clinical improvement should be evident within 48-72 hours of initiating therapy 3
- If no improvement occurs within 72 hours, consider MRSA, resistant organisms, or alternative diagnoses 3
- Complete the full antibiotic course even if symptoms resolve early 3
Important Caveats and Pitfalls
- Augmentin has no activity against MRSA, which is increasingly common in community-acquired skin infections 3
- The addition of clavulanic acid extends coverage to beta-lactamase-producing organisms, making it superior to amoxicillin alone for polymicrobial skin infections 4
- Gastrointestinal side effects (nausea, vomiting, diarrhea) are more common with Augmentin compared to other beta-lactams 1
- For patients with true penicillin allergy (immediate hypersensitivity), avoid Augmentin entirely and use alternatives like clindamycin 3, 2