Duration of Augmentin (Amoxicillin/Clavulanate) Treatment
The standard treatment duration for Augmentin is 10-14 days for most respiratory tract infections including sinusitis, with 4-7 days for intra-abdominal infections when adequate source control is achieved. 1, 2
Treatment Duration by Indication
Acute Bacterial Rhinosinusitis (Most Common Indication)
- Standard duration: 10-14 days for adults with acute bacterial sinusitis 1, 2
- Treatment should continue until the patient has been symptom-free for 7 days 1
- The American Academy of Otolaryngology recommends 10-14 days as the standard course 1, 2
Chronic Rhinosinusitis or Acute Exacerbations
- 14 days when using Augmentin 875/125 mg twice daily 3, 2
- Studies demonstrate faster symptom improvement at days 3-5 (81% vs 56% with cefuroxime) and significantly lower relapse rates (0% vs 8%) with this duration 3, 1
Intra-Abdominal Infections
- 4 days for immunocompetent, non-critically ill patients with adequate source control 3
- Up to 7 days for immunocompromised or critically ill patients with adequate source control 3
- Patients with ongoing signs of infection beyond 7 days require diagnostic re-evaluation 3
Perforated Peptic Ulcer
- 4 days for immunocompetent, non-critically ill patients if source control is adequate 3
- Up to 7 days for immunocompromised or critically ill patients based on clinical conditions and inflammation indices 3
Treatment Response Assessment
When to Evaluate Progress
- Assess clinical response at 72 hours (3 days) of treatment 3, 2
- If no improvement or worsening occurs, consider switching to an alternative antibiotic or re-evaluating the diagnosis 3, 1
- Patients with partial response should continue antibiotics for the full 10-14 day course 2
Alternative Duration Recommendations
- Some guidelines suggest 5-7 days may be sufficient for uncomplicated acute bacterial rhinosinusitis in adults, though this is not specifically validated for the 875/125 mg formulation 2
- French guidelines recommend 7-10 days for acute maxillary sinusitis 2
Pediatric Considerations
- 10 days is the standard duration for children with acute otitis media using the high-dose formulation (90 mg/kg/day) 4, 5
- The same 10-14 day duration applies to pediatric sinusitis 3, 6
Critical Pitfalls to Avoid
Do Not Treat Viral Infections
- Antibiotics should only be prescribed for confirmed bacterial sinusitis, not viral infections 6
- Treating viral sinusitis contributes to antibiotic resistance and provides no clinical benefit 1, 6
Do Not Stop Treatment Early
- Incomplete courses can lead to treatment failure and potential relapse 1
- Even if symptoms improve rapidly, complete the full prescribed duration 1, 2
Do Not Extend Beyond Necessary Duration
- For intra-abdominal infections with adequate source control, extending beyond 4-7 days is unnecessary and increases adverse effects 3
- Patients requiring antibiotics beyond 7 days for intra-abdominal infections need diagnostic investigation, not automatic continuation 3
Dosing Regimens by Duration
Standard Adult Dose
- 875/125 mg twice daily for 10-14 days 3, 1, 2
- This regimen demonstrated superior outcomes compared to three-times-daily dosing in clinical trials 3, 4
High-Dose Regimen
- 2000/125 mg twice daily (extended-release formulation) for drug-resistant pathogens 7
- Reserved for treatment failures, recent antibiotic use, or areas with high resistance 1, 2
Intra-Abdominal Infections
- 2 g/0.2 g every 8 hours for immunocompetent patients with adequate source control, duration 4 days 3