Return Precautions for Patients Taking Augmentin (Amoxicillin/Clavulanate)
Patients should return immediately if they develop severe or persistent diarrhea (especially watery or bloody stools), signs of allergic reaction, or if symptoms worsen or fail to improve within 2-3 days of starting treatment. 1
Immediate Return Precautions (Seek Care Urgently)
Gastrointestinal Warning Signs
- Severe diarrhea lasting more than 2-3 days, particularly watery and bloody stools with or without stomach cramps and fever 1
- This can occur even 2 or more months after the last dose of the antibiotic, indicating possible Clostridioides difficile infection 1
- Persistent nausea, vomiting, or inability to tolerate oral intake 1
Allergic Reactions
- Any signs of immediate-type hypersensitivity reaction including hives, difficulty breathing, bronchospasm, facial swelling, or throat tightness 2
- Amoxicillin/clavulanate contains a penicillin-class drug that can cause allergic reactions in susceptible individuals 1
- Skin rash with fever or other systemic symptoms 1
Treatment Failure Indicators
- Persistent fever beyond 2-3 days of appropriate antibiotic therapy 2
- Worsening of symptoms after initial improvement ("double sickening") 2
- Development of new symptoms such as increased pain, new fever, or spreading infection 2
Routine Follow-Up Precautions (Contact Provider)
Clinical Reassessment Timing
- Therapeutic efficacy should be assessed after 2-3 days of treatment, or earlier if the initial clinical picture is serious 2
- For respiratory infections, fever should resolve within 24 hours for pneumococcal infections, though 2-4 days may be necessary for other etiologies 2
- Cough may persist longer than fever resolution and does not necessarily indicate treatment failure 2
Lack of Improvement
- No improvement after 48 hours of therapy warrants clinical and potentially radiological reassessment 2
- Hospitalization should be considered after approximately 5 days if no improvement is observed or if the general condition worsens 2
Medication Adherence Counseling
Completion of Therapy
- Complete the full prescribed course even if feeling better early in treatment 1
- Skipping doses or not completing therapy decreases effectiveness and increases likelihood of bacterial resistance 1
Administration Instructions
- Take each dose with a meal or snack to reduce gastrointestinal upset 1
- For suspension formulations, keep refrigerated and shake well before each use 1
- Use proper measuring devices (dosing spoon or medicine dropper) for liquid formulations 1
Special Population Considerations
Neutropenic or Immunocompromised Patients
- Hospital readmission or continued hospitalization is required for persistent fever or signs of worsening infection 2
- Afebrile neutropenic patients who develop new signs or symptoms suggestive of infection should be evaluated and treated as high-risk patients 2
Patients with Documented Infections
- For clinically or microbiologically documented infections, antibiotics should continue for at least the duration of neutropenia (until ANC >500 cells/mm³) or longer if clinically necessary 2