What is the recommended dose of Augmentin (amoxicillin-clavulanate)?

Augmentin (Amoxicillin-Clavulanate) Dosing for Adults

For most adult infections, use Augmentin 875 mg/125 mg twice daily, or alternatively 500 mg/125 mg three times daily for mild-to-moderate infections. 1, 2

Standard Adult Dosing Regimens

Mild-to-Moderate Infections

• 500 mg/125 mg three times daily is the standard dose for mild-to-moderate ear/nose/throat, skin/skin structure, and genitourinary tract infections 1, 2
• Take at the start of meals to minimize gastrointestinal intolerance 2

Severe Infections or Respiratory Tract Infections

• 875 mg/125 mg twice daily is specifically recommended for:
  • Respiratory infections (acute bacterial rhinosinusitis, community-acquired pneumonia, acute exacerbations of chronic bronchitis) 1
  • Severe ear/nose/throat infections 2
  • Lower respiratory tract infections of any severity 2
  • Standard skin and soft tissue infections 1

Critical Dosing Warning

• Never substitute two 250 mg tablets for one 500 mg tablet, as this results in excessive clavulanate dosing and increased gastrointestinal side effects 1

Indication-Specific Dosing

Skin and Soft Tissue Infections

• Animal or human bites: 500 mg/125 mg twice daily 1
• Standard skin/soft tissue infections: 875 mg/125 mg twice daily 1

Respiratory Infections

• Duration: 5-7 days for pneumonia if afebrile for 48 hours and clinically stable 1
• Acute bacterial rhinosinusitis: 5-7 days total duration 1

Streptococcal Infections

• Recurrent streptococcal pharyngitis: 500 mg twice daily for 10 days 1
• Chronic streptococcal carriers: 500 mg twice daily for 10 days 1
• All streptococcal infections require a minimum 10-day course to prevent acute rheumatic fever 1, 2

H. pylori Infection

• Triple therapy: 1000 mg twice daily (every 12 hours) with clarithromycin 500 mg and lansoprazole 30 mg for 14 days 2
• Dual therapy: 1000 mg three times daily (every 8 hours) with lansoprazole 30 mg for 14 days 2

Lyme Disease with Cellulitis

• 500 mg three times daily for 14 days when covering both Lyme disease and bacterial cellulitis 1

Intravenous Dosing for Severe Infections

• 1.2 g IV every 8 hours for serious infections including:
  • Complicated intra-abdominal infections 1
  • Severe respiratory infections 1
  • Severe skin/soft tissue infections 1
• Duration: 4-7 days with adequate source control for intra-abdominal infections 1

Renal Impairment Dosing

Severe Renal Impairment

• GFR 10-30 mL/min: 500 mg or 250 mg every 12 hours (depending on infection severity) 2
• GFR <10 mL/min: 500 mg or 250 mg every 24 hours 2
• Hemodialysis: 500 mg or 250 mg every 24 hours, with an additional dose during and at the end of dialysis 2
• Critical warning: Patients with GFR <30 mL/min should NOT receive the 875 mg dose 2

Treatment Duration Principles

• Minimum duration: Continue for 48-72 hours beyond clinical improvement or bacterial eradication 2
• Streptococcal infections: Minimum 10 days regardless of clinical improvement 1, 2
• Complete the full prescribed course to prevent treatment failure and resistance development 1