Combining Augmentin and Doxycycline
Yes, Augmentin (amoxicillin/clavulanate) and doxycycline can be safely combined and are frequently used together in clinical practice for various infections. 1
Evidence from Clinical Guidelines
Multiple authoritative guidelines explicitly recommend this combination for specific infections:
Respiratory Infections
- Community-acquired pneumonia (CAP): The British Thoracic Society and WHO guidelines recommend combining amoxicillin/clavulanate with doxycycline as a second-line option for moderate CAP, particularly when beta-lactamase-producing Haemophilus influenzae is suspected. 1
- The American Thoracic Society/IDSA guidelines support β-lactam plus doxycycline combinations for outpatients with comorbidities and for hospitalized patients. 1
Bronchiectasis
- For acute exacerbations caused by beta-lactamase-positive H. influenzae, the British Thoracic Society explicitly lists amoxicillin/clavulanate 625 mg three times daily for 14 days with doxycycline 100 mg twice daily as a recommended second-line treatment. 1
Acute Bacterial Rhinosinusitis
- Guidelines recommend doxycycline as an alternative to macrolides when combined with β-lactams for patients with moderate disease or recent antibiotic exposure. 1
Pelvic Inflammatory Disease
- Clinical research demonstrates successful outpatient treatment combining Augmentin with doxycycline, with 35 of 47 patients (74%) completing therapy showing cure or improvement. 2
Clinical Considerations
When to use this combination:
- Suspected polymicrobial infections requiring both gram-positive/gram-negative coverage (Augmentin) and atypical pathogen coverage (doxycycline). 1
- Respiratory infections in patients with cardiopulmonary disease or recent antibiotic exposure. 1
- When MRSA coverage is needed alongside typical respiratory pathogens (doxycycline covers MRSA). 1
Dosing:
- Augmentin: 875/125 mg orally twice daily or 625 mg three times daily for adults. 1, 3
- Doxycycline: 100 mg orally twice daily. 1, 3
- Standard duration: 14 days for most respiratory infections. 1
Important Caveats
Contraindications for doxycycline:
- Pregnancy or lactation (use alternative macrolides or cephalosporins instead). 1
- Children under 8 years of age (risk of tooth discoloration). 1
- Advise sun avoidance due to photosensitivity risk. 1
Gastrointestinal side effects:
- This combination has higher rates of GI intolerance (nausea, diarrhea) compared to monotherapy—approximately 20% discontinuation rate in one study. 2
- Take doxycycline with 8 ounces of fluid and food to minimize esophageal irritation and GI upset. 1
No significant drug-drug interactions exist between these two antibiotics that would preclude their combined use. 1, 2