What are the durations for Augmentine (amoxicillin/clavulanate) and Doxycycline treatments?

Treatment Duration for Augmentin and Doxycycline

Augmentin (Amoxicillin-Clavulanate) Duration

For most common infections, Augmentin should be prescribed for 7-10 days, with specific durations depending on the infection type and severity. 1

Standard Duration by Infection Type:

• Respiratory tract infections (sinusitis, bronchitis, pneumonia): 7-10 days 2, 3
• Acute bacterial rhinosinusitis in adults: 5-7 days 4
• Acute otitis media in children: 10 days 1
• Skin and soft tissue infections: 7-10 days 4
• Uncomplicated urinary tract infections: 3-7 days 3
• Intra-abdominal infections with adequate source control: 4 days in immunocompetent, non-critically ill patients; up to 7 days in immunocompromised or critically ill patients 2

Critical Dosing Considerations:

• The 875 mg/125 mg formulation twice daily is specifically recommended for respiratory infections including acute bacterial rhinosinusitis, community-acquired pneumonia, and acute exacerbations of chronic bronchitis 4
• For more severe infections or respiratory tract involvement, use 875 mg/125 mg every 12 hours or 500 mg/125 mg every 8 hours 1
• Never substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet, as this results in excessive clavulanate dosing and increased gastrointestinal side effects 1

Doxycycline Duration

Doxycycline duration varies significantly by indication, ranging from 7-14 days for most infections to 60 days for bioterrorism-related exposures.

Standard Duration by Indication:

• Cutaneous anthrax (bioterrorism context): 60 days 2

  • This extended duration accounts for potential simultaneous aerosol exposure and risk of reactivation of latent infection 2
  • Standard cutaneous anthrax historically treated for 7-10 days, but bioterrorism scenarios require 60 days 2

• Inhalational anthrax: 60 days total (IV and oral combined) 2

  • Initial IV therapy followed by oral therapy when clinically appropriate 2
  • Extended duration necessary due to potential persistence of spores after aerosol exposure 2

• Bubonic plague: 10-14 days 2

  • Doxycycline 100 mg IV or PO twice daily for adults 2
  • Patients should be in respiratory isolation until completion of 48 hours of effective therapy 2

Dosing Specifications:

• Adults: 100 mg twice daily (oral or IV) 2
• Children >8 years and >45 kg: 100 mg every 12 hours 2
• Children >8 years and ≤45 kg: 2.2 mg/kg every 12 hours 2
• Children ≤8 years: 2.2 mg/kg every 12 hours (only for life-threatening illness) 2

Important Caveats:

• Doxycycline is not recommended during pregnancy or in children <8 years except for life-threatening infections such as Rocky Mountain spotted fever or bioterrorism exposures 2
• Adverse effects on developing teeth and bones are dose-related; short courses (7-14 days) before six months of gestation may be acceptable for life-threatening illness 2
• If meningitis is suspected, doxycycline may be less optimal due to poor central nervous system penetration 2