Augmentin Injection Dosing for Adults
For adults requiring intravenous Augmentin, administer 1.2 g (1000 mg amoxicillin/200 mg clavulanate) every 8 hours by short IV infusion, or 600 mg every 8 hours for less severe infections. 1, 2
Standard IV Dosing Regimens
Moderate to Severe Infections
- 1.2 g IV every 8 hours is the standard dose for most hospitalized patients with moderate to severe bacterial infections 1, 2
- This provides peak serum concentrations exceeding 100 mcg/ml for amoxicillin and 14 mcg/ml for clavulanic acid, well above therapeutic thresholds 2
- Administer as a short IV infusion over 30 minutes rather than bolus injection 2
Mild to Moderate Infections
- 600 mg IV every 8 hours can be used for less severe infections or as step-down therapy 1
- This lower dose maintains adequate serum and urinary concentrations for therapeutic effect 2
Surgical Prophylaxis Regimens
For prevention of postoperative infections in abdominal surgery, use one of these evidence-based protocols 1:
- Ultra-short prophylaxis: 1.2 g IV at induction of anesthesia only
- Short-term prophylaxis: 1.2 g IV at induction, then 600 mg at 8 and 16 hours post-op
- Middle-term prophylaxis: 1.2 g IV at induction, then 600 mg every 8 hours for 2 days
- Long-term prophylaxis: 1.2 g IV at induction, then 600 mg every 8 hours for 3 days
The ultra-short or short-term regimens are preferred to minimize antibiotic exposure while maintaining efficacy, as prolonged prophylaxis beyond 24-48 hours offers no additional benefit 1
Pediatric Dosing Considerations
For children requiring IV Augmentin 3:
- 100-200 mg/kg/day divided into 3-4 doses
- Administer by short IV infusion
- This achieves 92% bacteriological success rates in pediatric infections 3
Pharmacokinetic Considerations
Effect of Probenecid
- Probenecid increases amoxicillin serum concentrations but does not affect clavulanic acid levels 2
- Consider this interaction if probenecid is co-administered for other indications 2
Two-Compartment Kinetics
- Both amoxicillin and clavulanic acid follow two-compartment pharmacokinetic models 2
- Dosing every 8 hours maintains therapeutic concentrations throughout the dosing interval 2
Transition to Oral Therapy
When clinically appropriate, transition from IV to oral Augmentin 4, 5:
- 875 mg/125 mg orally twice daily for most infections
- 500 mg/125 mg orally three times daily for milder infections
- Do not substitute two 250 mg doses for one 500 mg dose due to excessive clavulanate and increased GI side effects 4
Renal Dose Adjustments
For patients with severe renal impairment 4:
- GFR 10-30 mL/min: 250-500 mg every 12 hours
- GFR <10 mL/min: 250-500 mg every 24 hours
- Adjust based on creatinine clearance to prevent drug accumulation 4
Common Pitfalls to Avoid
- Never administer as rapid IV bolus—always infuse over 30 minutes to minimize adverse reactions 2
- Do not extend prophylaxis beyond 3 days in surgical patients without documented infection, as this promotes resistance without improving outcomes 1
- Monitor for mild exanthema if transitioning to oral formulation, though this is typically transient and self-limited 3
- Ensure adequate hydration to maintain urinary concentrations, particularly for urinary tract infections 6, 2