What is the typical dosage of Augmentin (amoxicillin/clavulanate) for adults with bacterial infections?

Oral Augmentin Dosing for Adults with Bacterial Infections

For most mild-to-moderate bacterial infections in adults, use Augmentin 500 mg/125 mg every 12 hours or 250 mg/125 mg every 8 hours, but for respiratory tract infections and more severe infections, use 875 mg/125 mg every 12 hours or 500 mg/125 mg every 8 hours. 1

Standard Adult Dosing Algorithm

Mild-to-Moderate Infections (Non-Respiratory):

• 500 mg/125 mg every 12 hours (preferred for compliance) 1
• Alternative: 250 mg/125 mg every 8 hours 1

Respiratory Tract Infections & More Severe Infections:

• 875 mg/125 mg every 12 hours (first-line choice) 1, 2
• Alternative: 500 mg/125 mg every 8 hours 1

High-Risk Respiratory Infections:

• 2000 mg/125 mg (2 g/125 mg) twice daily for patients with recent antibiotic use, treatment failure, or areas with high penicillin-resistant S. pneumoniae prevalence 2, 3

Specific Clinical Indications

Acute Bacterial Rhinosinusitis:

• 875 mg/125 mg twice daily for 5-7 days 2, 4
• Use high-dose (2000 mg/125 mg twice daily) if recent antibiotic exposure within 4-6 weeks 3

Community-Acquired Pneumonia:

• 875 mg/125 mg twice daily for 7 days 2
• Continue until afebrile for 48 hours and clinically stable 4

Skin and Soft Tissue Infections:

• 875 mg/125 mg twice daily 4

Animal or Human Bites:

• 500 mg/125 mg twice daily 2
• Alternative: 875 mg/125 mg twice daily 4

Streptococcal Pharyngitis (Chronic Carriers Only):

• 500 mg twice daily for 10 days 4
• Note: Augmentin is NOT first-line for acute strep throat; use penicillin V or amoxicillin alone 4

Critical Dosing Pitfalls to Avoid

Never substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet - this doubles the clavulanate dose (250 mg vs 125 mg) and significantly increases gastrointestinal side effects, particularly diarrhea 1, 2

The clavulanate component is fixed at 125 mg per dose in standard adult formulations regardless of amoxicillin content 2

Different formulations are NOT interchangeable - the 250 mg/125 mg tablet contains different clavulanate ratios than chewable tablets 1

Administration Guidelines

Take at the start of a meal to enhance clavulanate absorption and minimize gastrointestinal intolerance 1, 2

Duration of therapy:

• Uncomplicated sinusitis: 5-7 days 2, 4
• Streptococcal infections: minimum 10 days to prevent acute rheumatic fever 2, 4
• Pneumonia: typically 5-7 days if afebrile for 48 hours 4

When to Escalate or Change Therapy

If no clinical improvement after 72 hours, switch to a respiratory fluoroquinolone (levofloxacin or moxifloxacin) or escalate to high-dose amoxicillin/clavulanate if not already used 2

For severe infections requiring hospitalization, consider IV formulation at 1.2 g every 8 hours, then switch to oral as soon as clinically appropriate 4, 3