Augmentin Dosing for Tooth Infections
For adults with tooth infections, Augmentin (amoxicillin/clavulanate) should be dosed at 875 mg/125 mg twice daily for 7-10 days, with the understanding that surgical intervention (drainage, extraction, or root canal) is essential and antibiotics alone are insufficient. 1, 2
Standard Adult Dosing Regimen
- The FDA-approved adult dose is 875 mg/125 mg every 12 hours for more severe infections, which includes dental infections 2
- An alternative regimen is 500 mg/125 mg every 8 hours, though the twice-daily dosing is preferred for compliance 2
- Duration should be 7-10 days based on clinical guidelines for dental infections 1
- Take at the start of meals to minimize gastrointestinal side effects and enhance clavulanate absorption 2
Critical Clinical Considerations
Antibiotics are adjunctive therapy only—surgical intervention must not be delayed. The European Society of Endodontology emphasizes that antibiotics alone without drainage, extraction, or root canal therapy are insufficient for treating dental abscesses 1. The primary treatment is surgical, with antibiotics serving as an adjunct 1.
When to Use Augmentin vs. Plain Amoxicillin
- Augmentin is preferred over plain amoxicillin when beta-lactamase producing organisms are suspected or for more complex infections 1
- For simple, uncomplicated tooth infections without recent antibiotic use, plain amoxicillin 500 mg three times daily may be adequate 1
- Augmentin provides coverage against beta-lactamase producing oral flora, which is increasingly common 3
Efficacy Data
- In odontogenic infections, amoxicillin/clavulanate 875 mg/125 mg twice daily achieved 88.2% clinical success, comparable to clindamycin (89.7%) 3
- The combination showed higher clinical success rates at Day 5 compared to clindamycin 3
- Both clinical and bacteriological responses were favorable in dental infection studies 3
Penicillin Allergy Alternatives
For patients with true penicillin allergy, clindamycin 300 mg three times daily for 7-10 days is the recommended alternative 1. Avoid cephalosporins in patients with immediate (Type I) hypersensitivity reactions to penicillin 4.
Common Pitfalls to Avoid
- Do not substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet—they contain different amounts of clavulanic acid and are not equivalent 2
- Do not delay definitive surgical treatment while waiting for antibiotics to work—this is the most critical error in managing dental infections 1
- Diarrhea is the most common adverse effect (occurring in approximately 14-15% of patients), but is generally mild 2, 3