From the Guidelines
For adult patients with otitis media, the maximum recommended dose of Augmentin is not explicitly stated in the provided evidence, but based on the recommended dose of amoxicillin, which is 80 to 90 mg per kg per day 1, the maximum dose of Augmentin can be extrapolated. Considering the typical adult weight range, the maximum dose would be approximately 875 mg amoxicillin/125 mg clavulanate taken twice daily. The choice of Augmentin as a treatment option should be based on the anticipated clinical response and the microbiologic flora likely to be present, with amoxicillin being recommended as first-line therapy for AOM due to its effectiveness against susceptible and intermediate resistant pneumococci 1. Some key points to consider when prescribing Augmentin for adult patients with otitis media include:
- The optimal duration of therapy is uncertain, but typical treatment duration is 5-7 days for uncomplicated cases
- The medication should be taken with food to minimize gastrointestinal side effects
- Patients should complete the entire course of antibiotics even if symptoms improve before finishing the prescription
- Common side effects include diarrhea, nausea, and skin rash
- If a patient has a history of penicillin allergy, an alternative antibiotic should be selected, such as cefdinir, cefpodoxime, or cefuroxime 1.
From the FDA Drug Label
For more severe infections and infections of the respiratory tract, the dose should be one 875 mg/125 mg amoxicillin and clavulanate potassium tablet every 12 hours or one 500 mg/125 mg amoxicillin and clavulanate potassium tablet every 8 hours. Patients Weighing 40 kg or More: Pediatric patients weighing 40 kg or more should be dosed according to adult recommendations Table 1: Dosing in Patients Aged 12 weeks (3 months) and Older INFECTIONDOSING REGIMEN Every 12 hoursEvery 12 hours 200 mg/5 mL or 400 mg/5 mL oral suspension a125 mg/5 mL or 250 mg/5 mL oral suspension a Otitis media b, sinusitis, lower respiratory tract infections, and more severe infections45 mg/kg/day every 12 hours40 mg/kg/day every 8 hours
The maximum dose of Augmentin for an adult with otitis media is 875 mg/125 mg every 12 hours or 500 mg/125 mg every 8 hours 2 2.
- Key points:
- The dose for more severe infections, including otitis media, is one 875 mg/125 mg tablet every 12 hours or one 500 mg/125 mg tablet every 8 hours.
- Patients weighing 40 kg or more should be dosed according to adult recommendations.
- For otitis media, the recommended dose is 45 mg/kg/day every 12 hours or 40 mg/kg/day every 8 hours for patients aged 12 weeks and older.
From the Research
Augmentin Dose for Adult Otitis Media
- The maximum dose of Augmentin (amoxicillin/clavulanate) for adults with otitis media is not explicitly stated in the provided studies.
- However, the studies suggest that amoxicillin/clavulanate is effective in treating otitis media in children, and the dosage ranges from 45/6.4 mg/kg/day to 90/12.8 mg/kg/day 3, 4, 5.
- For adults, the typical dose of Augmentin for otitis media is 500/125 mg or 875/125 mg taken every 12 hours 3.
- It is essential to note that the dosage and frequency of Augmentin may vary depending on the severity of the infection, the patient's renal function, and other factors.
Comparison of Augmentin with Other Antibiotics
- Studies have compared the efficacy of amoxicillin/clavulanate with other antibiotics, such as azithromycin, in treating otitis media 6, 4, 5.
- The results suggest that amoxicillin/clavulanate may have superior bacteriologic and clinical efficacy compared to azithromycin in children with otitis media 5.
- However, the studies do not provide direct evidence for the maximum dose of Augmentin for adult otitis media.
Clinical Efficacy and Safety
- The studies demonstrate that amoxicillin/clavulanate is effective in eradicating bacterial pathogens from middle ear fluid and improving clinical symptoms in patients with otitis media 3, 4, 5.
- The safety profile of Augmentin is generally well-tolerated, with gastrointestinal side effects being the most common adverse event 7.