From the Guidelines
The combined use of amoxicillin/clavulanate (Augmentin) and Doxycycline is indicated for the treatment of community-acquired pneumonia in outpatient adults with comorbidities, such as chronic heart, lung, liver, or renal disease; diabetes mellitus; alcoholism; malignancy; or asplenia, as recommended by the American Thoracic Society and Infectious Diseases Society of America 1.
Key Points
- The recommended dose of amoxicillin/clavulanate is 500 mg/125 mg three times daily, or 875 mg/125 mg twice daily, or 2,000 mg/125 mg twice daily.
- The recommended dose of doxycycline is 100 mg twice daily.
- This combination therapy is recommended for patients with comorbidities, as it provides coverage for a broader range of pathogens, including those that may be resistant to single-agent therapy.
- The use of this combination therapy is supported by moderate-quality evidence, and is considered a strong recommendation by the American Thoracic Society and Infectious Diseases Society of America 1.
Clinical Considerations
- The choice of antibiotic therapy should be based on the patient's individual risk factors, including the presence of comorbidities and the likelihood of antibiotic-resistant pathogens.
- The use of combination therapy, such as amoxicillin/clavulanate and doxycycline, may be preferred in patients with comorbidities, as it provides broader coverage and may reduce the risk of treatment failure.
- The duration of therapy should be based on the severity of the illness and the patient's response to treatment, and should be guided by clinical judgment and evidence-based recommendations 1.
From the Research
Indications for Amoxicillin/Clavulanate (Augmentin)
- The combination of amoxicillin and clavulanate is indicated for the treatment of various infections, including:
- Community-acquired respiratory tract infections, such as bacterial sinusitis, acute otitis media, community-acquired pneumonia, and acute exacerbations of chronic bronchitis 2
- Skin infections, including primary skin sepsis, infected eczema, infected trauma, and leg ulcers 3
- Urinary tract infections, particularly those caused by multiply resistant bacteria 4
- Complicated urinary tract infections, otitis media, sinusitis, and respiratory tract infections 5
Combination with Doxycycline
- There is no direct evidence in the provided studies to support the combined use of amoxicillin/clavulanate (Augmentin) and Doxycycline.
- However, amoxicillin/clavulanate is often used as empiric therapy for various infections, and doxycycline is also used to treat a range of bacterial infections, including respiratory tract infections and skin infections.
- The decision to use these antibiotics in combination would depend on the specific clinical scenario and the suspected or confirmed causative pathogens 6
Important Considerations
- Amoxicillin/clavulanate has a broad spectrum of antibacterial activity and is effective against many beta-lactamase-producing pathogens 2, 5
- The combination of amoxicillin and clavulanate has a favourable pharmacokinetic/pharmacodynamic profile, which contributes to its high bacteriological and clinical efficacy 2
- However, the use of amoxicillin/clavulanate is associated with a higher risk of gastrointestinal side effects, including Clostridium difficile infection, compared to amoxicillin alone 6