Augmentin Dosing for Adults with Uncomplicated Infections
Standard Adult Dosing
For adults with mild to moderate uncomplicated infections, the recommended dose is 500 mg/125 mg every 12 hours or 250 mg/125 mg every 8 hours, taken at the start of a meal to enhance absorption and minimize gastrointestinal side effects. 1
Dosing by Infection Severity
Mild to Moderate Infections:
- 500 mg/125 mg every 12 hours, OR
- 250 mg/125 mg every 8 hours 1
More Severe Infections and Respiratory Tract Infections:
- 875 mg/125 mg every 12 hours (preferred), OR
- 500 mg/125 mg every 8 hours 1
High-Dose Regimen (for resistant pathogens):
- 2 g/125 mg twice daily for adults with risk factors including recent antibiotic use, treatment failure, close contact with daycare children, smoking exposure, age >65 years, immunocompromised status, or moderate-to-severe infections 2
Specific Infection Types
Acute Bacterial Rhinosinusitis (ABRS):
- Amoxicillin-clavulanate is preferred over amoxicillin alone in adults (weak recommendation) 3, 2
- Standard dose: 500 mg/125 mg every 8 hours (625 mg formulation three times daily) 2
- High-dose: 2 g/125 mg twice daily for patients with risk factors 2
- Duration: 5-7 days (as effective as 10-14 days for uncomplicated cases) 3, 2
Respiratory Infections (including bronchiectasis exacerbations):
- 625 mg three times daily for 14 days 2
- Covers beta-lactamase producing Haemophilus influenzae and MSSA 2
Urinary Tract Infections:
- 375 mg three times daily shows approximately 70% success rate for amoxicillin-resistant organisms 4
Critical Dosing Considerations
Important Formulation Rules:
- Two 250 mg/125 mg tablets ≠ one 500 mg/125 mg tablet (both contain 125 mg clavulanic acid, making them non-interchangeable) 1
- Always take at the start of a meal to enhance clavulanate absorption and reduce GI intolerance 1
When to Use High-Dose Regimen:
- Recent antibiotic use (within 30 days) 2
- Failed previous antibiotic therapy 2
- Frontal or sphenoidal sinusitis 2
- High prevalence of resistant bacteria (>10% penicillin-resistant S. pneumoniae) 2
- Moderate to severe infections 2
- Immunocompromised patients 2
Common Pitfalls to Avoid
Formulation Errors:
- Do not substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet—this doubles the clavulanic acid dose unnecessarily and increases diarrhea risk 1
Duration Errors:
- For uncomplicated ABRS in adults, 5-7 days is sufficient; avoid unnecessarily prolonged courses 3, 2
- For respiratory infections with beta-lactamase producing organisms, ensure full 14-day course 2
Coverage Misconceptions: