For how long is Amoxicillin/Clavulanate 875/125 mg typically prescribed?

Duration of Amoxicillin/Clavulanate 875/125 mg Treatment

Amoxicillin/clavulanate 875/125 mg should be prescribed for 10-14 days for acute bacterial sinusitis, which is the most common indication for this specific dosing regimen. 1, 2

Standard Treatment Duration by Indication

Acute Bacterial Sinusitis (Primary Indication)

• The recommended duration is 10-14 days for adults with acute bacterial sinusitis 1, 2
• Treatment should continue until the patient is symptomatically improved to near normal 1
• Some clinicians extend therapy for 7 days after complete symptom resolution 2
• Assessment of treatment response should occur at 3-5 days; if no improvement is seen, consider switching antibiotics 1, 2

Chronic Rhinosinusitis or Acute Exacerbations

• 14 days is the standard duration when amoxicillin/clavulanate 875/125 mg twice daily is used for chronic rhinosinusitis 1
• This duration showed significant improvement in symptoms at days 3-5 compared to cefuroxime, with 81% of patients improved versus 56% 1

Alternative Shorter Durations (Context-Specific)

• 5-7 days may be sufficient for uncomplicated acute bacterial rhinosinusitis in adults, according to more recent IDSA recommendations 3
• French guidelines support 7-10 days for acute maxillary sinusitis in both adults and children 1
• Cefuroxime-axetil and cefpodoxime-proxetil have demonstrated efficacy in 5 days, but this shorter duration is not specifically validated for amoxicillin/clavulanate 875/125 mg 1

Clinical Decision Algorithm

For partial response at end of initial course:

• Continue treatment for an additional 10-14 days 1, 2
• Reassess after total of 21-28 days of therapy 1

For poor response after 3-5 days:

• Switch to broader-spectrum coverage rather than extending duration 1, 2
• Consider high-dose amoxicillin/clavulanate (90 mg/kg amoxicillin component, not exceeding 2g every 12 hours) 1, 2

For complete resolution before 10 days:

• Complete the full 10-14 day course to prevent relapse and resistance 1, 2
• Early discontinuation is not recommended even with symptom improvement 2

Important Caveats

Regional resistance patterns matter: In areas with high antibiotic resistance, the full 10-14 day course is particularly important to achieve bacteriologic eradication 1, 2

Avoid common dosing errors: Do not substitute two 250 mg tablets for one 500 mg tablet, as this results in excessive clavulanate dosing and increased gastrointestinal side effects 3

High-dose formulations are different: Recent evidence shows that high-dose amoxicillin/clavulanate (875 mg + 875 mg twice daily) does not provide additional benefit over standard-dose 875/125 mg for acute sinusitis, with similar efficacy (44.3% vs 36.4% improvement at day 3) but comparable diarrhea rates 4