What is the recommended dosage of Augmentin (amoxicillin/clavulanate)?

Augmentin Dosage Recommendations

Standard Adult Oral Dosing

For most mild-to-moderate infections in adults, Augmentin 500 mg/125 mg three times daily or 875 mg/125 mg twice daily is the recommended dosage. 1

Infection-Specific Dosing

Respiratory Tract Infections:

• 875 mg/125 mg twice daily is specifically recommended for respiratory infections including acute bacterial rhinosinusitis, community-acquired pneumonia, and acute exacerbations of chronic bronchitis 1
• Treatment duration for uncomplicated acute bacterial rhinosinusitis is 5-7 days 1
• For pneumonia, treatment typically continues for 5-7 days if afebrile for 48 hours and clinically stable 2

Skin and Soft Tissue Infections:

• 875 mg/125 mg twice daily for standard infections 1
• 500 mg/125 mg twice daily for animal or human bites 1
• Duration: 7-10 days 3

Streptococcal Infections:

• For chronic streptococcal carriers with recurrent symptomatic episodes: 500 mg (amoxicillin component) twice daily for 10 days 1
• Critical: Complete the full 10-day course to prevent acute rheumatic fever 1, 4

Pediatric Oral Dosing (≥3 months and <40 kg)

Mild-to-Moderate Infections:

• 25 mg/kg/day (amoxicillin component) divided every 12 hours, or 20 mg/kg/day divided every 8 hours 4

Severe Infections:

• 45 mg/kg/day divided every 12 hours, or 40 mg/kg/day divided every 8 hours 4

Infants <3 months:

• Maximum 30 mg/kg/day divided every 12 hours due to immature renal function 4

Chronic Streptococcal Carriers (Pediatric):

• 40 mg/kg/day in three equally divided doses for 10 days (maximum 2000 mg amoxicillin per day) 1

Intravenous Dosing

Adult IV:

• 1.2 g IV every 8 hours for most serious infections including complicated intra-abdominal infections, severe respiratory infections, and severe skin/soft tissue infections 1, 3
• Duration: 4-7 days with adequate source control for intra-abdominal infections 1

Pediatric IV:

• For complicated intra-abdominal infections: 200 mg/kg/day divided every 6 hours (not to exceed adult dosing) 3

Critical Dosing Considerations

Renal Impairment:

• GFR 10-30 mL/min: 500 mg or 250 mg every 12 hours 4
• GFR <10 mL/min: 500 mg or 250 mg every 24 hours 4
• Hemodialysis: 500 mg or 250 mg every 24 hours, with additional dose during and at end of dialysis 4
• Patients with GFR <30 mL/min should NOT receive the 875 mg dose 4

Important Warnings

Formulation Errors to Avoid:

• Never substitute two 250 mg tablets for one 500 mg tablet as this results in excessive clavulanate dosing 1
• Do not confuse IV dosing (1.2 g every 8 hours) with oral dosing (875/125 mg twice daily) 3

Administration:

• Take at the start of a meal to minimize gastrointestinal intolerance 4
• Continue treatment for minimum 48-72 hours beyond symptom resolution or bacterial eradication 4