Is Augmentin (amoxicillin-clavulanate) used to treat urinary tract infections (UTIs) in males?

From the Guidelines

Augmentin (amoxicillin-clavulanate) is an appropriate antibiotic choice for treating urinary tract infections (UTIs) in men, with a recommended treatment duration of 7-14 days. The typical adult dosage for uncomplicated UTIs is 500 mg/125 mg taken orally every 12 hours, or 875 mg/125 mg every 12 hours, with the longer duration often recommended for male UTIs due to anatomical differences and potential involvement of the prostate gland 1. According to the European Association of Urology guidelines, male UTIs are considered complicated and require longer treatment courses than women 1.

Some key points to consider when treating male UTIs with Augmentin include:

• Completing the entire prescribed course even if symptoms improve
• Drinking plenty of water to help flush out bacteria
• Being aware of possible side effects, including diarrhea, nausea, and rash
• Monitoring for symptoms that worsen or don't improve within 48-72 hours, which may require medical reassessment and alternative antibiotics or further evaluation for underlying conditions 1.

It's also important to note that the microbial spectrum of complicated UTIs is greater than for uncomplicated UTIs, and antimicrobial resistance is more likely, with common species including E. coli, Proteus spp., Klebsiella spp., Pseudomonas spp., Serratia spp., and Enterococcus spp. 1. Therefore, it is crucial to tailor antimicrobial therapy based on local resistance patterns and specific host factors, and to perform urine culture and susceptibility testing to guide treatment.

From the FDA Drug Label

1. Clinical Studies 14. 1 Lower Respiratory Tract and Complicated Urinary Tract Infections Data from 2 pivotal trials in 1,191 patients treated for either lower respiratory tract infections or complicated urinary tract infections In one of these pivotal trials, patients with either pyelonephritis (n = 361) or a complicated urinary tract infection (i.e., patients with abnormalities of the urinary tract that predispose to relapse of bacteriuria following eradication, n = 268) were randomized (1:1) to receive either 875 mg/125 mg amoxicillin and clavulanate potassium tablets every 12 hours (n = 308) or 500 mg/125 mg amoxicillin and clavulanate potassium tablets every 8 hours (n = 321) The number of bacteriologically evaluable patients was comparable between the two dosing regimens. Amoxicillin and clavulanate potassium tablets produced comparable bacteriological success rates in patients assessed 2 to 4 days immediately following end of therapy

Augmentin (amoxicillin-clavulanate) can be used for the treatment of complicated urinary tract infections, including pyelonephritis, in adults.

• The bacteriological efficacy rates were comparable between the two dosing regimens (875 mg/125 mg every 12 hours and 500 mg/125 mg every 8 hours) at different time points post-therapy 2. However, there is no specific information about the use of Augmentin for male UTI in the provided drug label.

From the Research

Augmentin for Male UTI

• Augmentin (amoxycillin and clavulanic acid) is a potential treatment option for urinary tract infections (UTIs), including those in male patients 3.
• The combination of amoxycillin and clavulanic acid in Augmentin reduces the level of resistance in most Gram-negative urinary pathogens, making it effective against multiply resistant bacteria 3.
• Clinical trials have shown a success rate of about 70% for amoxycillin-resistant organisms when treated with Augmentin 3.
• However, the effectiveness of Augmentin for male UTI may vary depending on the local resistance patterns and the severity of the infection 4.
• Other treatment options for UTIs, including those caused by antibiotic-resistant bacteria, may include nitrofurantoin, fosfomycin, pivmecillinam, fluoroquinolones, and cephalosporins 5, 6, 4.

Considerations for Male UTI Treatment

• The microbiology of UTIs in male patients can be more unpredictable compared to female patients, making treatment decisions more challenging 7.
• Data from clinical trials specific to male patients are relatively scarce, which can limit the availability of evidence-based treatment guidelines 7.
• Empirical therapy for male UTI should be chosen based on the severity of illness and the potential for antimicrobial resistance, and may need to be tailored to local resistance patterns 5, 4.
• Source control may be necessary in severely ill patients, and the need for hospitalization or parenteral antibiotics should be considered on a case-by-case basis 5, 7.