What is the dosing regimen for Augmentin (amoxicillin/clavulanate) 500/125 for cellulitis?

Dosing Augmentin 500/125 for Cellulitis

For uncomplicated cellulitis, dose Augmentin (amoxicillin-clavulanate) 500 mg/125 mg orally every 12 hours for 5 days, extending only if clinical improvement has not occurred by day 5. 1, 2

Standard Dosing Regimen

• Augmentin 500/125 mg twice daily (every 12 hours) is the FDA-approved dosing for adults with skin and soft tissue infections 3
• Take at the start of meals to enhance clavulanate absorption and minimize gastrointestinal side effects 3
• The 500/125 mg formulation contains 500 mg amoxicillin and 125 mg clavulanic acid per tablet 3

Treatment Duration

• 5 days is adequate if clinical improvement occurs, as recommended by the Infectious Diseases Society of America 1, 2
• Extend treatment beyond 5 days only if the infection has not improved within this initial period 4, 1
• The traditional 7-14 day courses are no longer necessary for uncomplicated cases 4

When Augmentin is Appropriate

Augmentin provides coverage for both streptococci (the primary cause of typical cellulitis) and staphylococci, making it a reasonable choice for:

• Typical nonpurulent cellulitis where broader coverage is desired 1
• Cellulitis associated with human or animal bites, where it is specifically recommended at 875/125 mg twice daily 4
• Situations where you want single-agent coverage for both streptococci and common skin flora 4

Important Caveats

Beta-lactam monotherapy without clavulanate (such as cephalexin or penicillin) is actually preferred for typical uncomplicated cellulitis, as MRSA is uncommon and beta-lactam treatment succeeds in 96% of cases 1. Augmentin adds unnecessary anaerobic and beta-lactamase coverage for most cellulitis cases 1.

• Do not substitute two 250/125 mg tablets for one 500/125 mg tablet, as this doubles the clavulanic acid dose and increases side effects 3
• MRSA coverage is usually unnecessary for typical cellulitis; add it only for penetrating trauma, purulent drainage, injection drug use, or known MRSA colonization 1, 2
• Elevate the affected extremity to hasten improvement 1, 2

Dosing Adjustments

• For more severe infections or respiratory involvement, the FDA label recommends 875/125 mg every 12 hours instead 3
• Pediatric patients ≥40 kg should follow adult dosing recommendations 3
• Patients with difficulty swallowing may use suspension formulations as alternatives 3