Augmentin XR Dosage
For adults and adolescents with community-acquired respiratory tract infections, Augmentin XR is dosed as 2000 mg amoxicillin/125 mg clavulanate (two 1000 mg/62.5 mg extended-release tablets) taken orally every 12 hours for 7-10 days, administered at the start of a meal to enhance absorption and minimize gastrointestinal side effects. 1, 2
Standard Dosing Regimen
- The recommended dose is 2000 mg/125 mg twice daily (every 12 hours) taken with food 1, 2, 3
- Each dose consists of two extended-release tablets, each containing 1000 mg amoxicillin and 62.5 mg clavulanate 2
- Administration at the start of a meal is critical—it enhances clavulanate absorption and reduces gastrointestinal intolerance 4
Specific Indications
Augmentin XR is specifically indicated for:
- Community-acquired pneumonia caused by resistant pathogens 2, 3
- Acute bacterial sinusitis in adults with risk factors for resistant organisms 5
- Acute exacerbations of chronic bronchitis 2, 3
When to Use Augmentin XR vs. Standard Formulations
Use Augmentin XR (high-dose formulation) when patients have:
- Recent antimicrobial use within the past 4-6 weeks 5
- Geographic areas with high prevalence (>10%) of penicillin-resistant Streptococcus pneumoniae 5, 6
- Moderate to severe respiratory infections 5
- Age over 65 years 7
- Immunocompromised status or significant comorbidities 7
- Close contact with children in daycare settings 6, 7
- Failed previous antibiotic therapy 5, 7
Duration of Therapy
- For acute bacterial sinusitis: 5-7 days (as effective as 10-day courses) 5, 7
- For community-acquired pneumonia: 7-10 days 2, 3
- For acute exacerbations of chronic bronchitis: 7-10 days 2
Pharmacokinetic Advantage
- The extended-release formulation maintains plasma amoxicillin concentrations above 4 mcg/mL for approximately 49% of the dosing interval 2, 3
- This pharmacokinetic profile provides effective coverage against S. pneumoniae strains with MICs up to 4 mcg/mL, exceeding the standard susceptibility breakpoint of ≤2 mcg/mL 2, 3
Critical Dosing Pitfalls to Avoid
- Never substitute two standard 1000 mg/125 mg tablets for Augmentin XR—the extended-release formulation has unique pharmacokinetics that cannot be replicated with immediate-release tablets 1
- Do not use Augmentin XR in patients with severe renal impairment (GFR <30 mL/min)—these patients require dose adjustment with standard formulations 4
- Augmentin XR is not approved for pediatric use—children requiring high-dose therapy should receive Augmentin ES-600 (90 mg/kg/day amoxicillin with 6.4 mg/kg/day clavulanate in two divided doses) 6, 1, 8
Tolerability Profile
- The tolerability of Augmentin XR is comparable to conventional amoxicillin/clavulanate formulations 2, 3
- Taking the medication with food significantly reduces gastrointestinal adverse effects 4
- The incidence of diarrhea is similar between high-dose and standard-dose formulations when taken appropriately 2