What is the typical treatment duration for amoxicillin-clavulanate (Augmentin) 875/125 milligrams every 12 hours (Q 12hrs)?

Treatment Duration for Amoxicillin-Clavulanate 875/125 mg Q12h

The standard treatment duration for amoxicillin-clavulanate 875/125 mg every 12 hours is 10-14 days for most common indications including sinusitis, with shorter 5-7 day courses appropriate for specific infections like dental abscesses or uncomplicated cases. 1, 2

Duration by Clinical Indication

Acute Bacterial Sinusitis (Most Common Indication)

• Standard duration: 10-14 days for adults with acute bacterial sinusitis 1, 2
• The American Academy of Otolaryngology-Head and Neck Surgery specifically recommends this 10-14 day course for the 875/125 mg twice-daily formulation 1, 2
• Treatment should continue until the patient has been symptom-free for 7 days 2
• Assess clinical response at 72 hours (3 days); if no improvement or worsening occurs, switch to an alternative antibiotic 1, 2

Dental/Odontogenic Infections

• 5-7 days when used as adjunctive therapy with surgical drainage 3
• The American Dental Association emphasizes that antibiotics serve only as adjunctive therapy, with surgical drainage being the primary treatment 3
• Critical pitfall: Never prescribe antibiotics without addressing the source of infection surgically, as this leads to treatment failure 3

Intra-Abdominal Infections

• 4 days for immunocompetent, non-critically ill patients with adequate source control 4
• Up to 7 days for immunocompromised or critically ill patients with adequate source control 4
• Patients with ongoing signs of infection beyond 7 days warrant diagnostic investigation 4

Animal or Human Bites

• Standard duration not explicitly specified in guidelines, but typically follows the 5-7 day course for soft tissue infections 4
• The 875/125 mg twice-daily formulation is listed as the preferred oral regimen for animal bites 4

Acute Otitis Media (Pediatric Context)

• 10 days is the standard duration used in high-quality trials demonstrating efficacy 4
• Studies showing benefit used amoxicillin-clavulanate for the full 10-day course 4

Evidence Quality Considerations

The 10-14 day recommendation for sinusitis is the most strongly supported duration across multiple high-quality guidelines 1, 2. This is based on:

• Comparative efficacy data showing that 14 days of treatment resulted in 0% clinical relapse at weeks 2-4 versus 8% with shorter courses 2
• Faster symptom improvement at days 3-5 (81% vs 56%) with the twice-daily regimen 2

Shorter 5-7 day courses are gaining acceptance for specific conditions:

• A 5-day course of high-dose amoxicillin-clavulanate (2000/125 mg) was shown to be as effective as 7 days of standard dose for acute exacerbations of chronic bronchitis 5
• The French Society of Clinical Microbiology recommends 7-10 days for acute maxillary sinusitis 4
• The Infectious Diseases Society of America suggests 5-7 days may be sufficient for uncomplicated acute bacterial rhinosinusitis 1

Common Pitfalls to Avoid

• Do not treat viral sinusitis with antibiotics, as this contributes to resistance without providing benefit 2
• Do not stop treatment early even if symptoms improve, as incomplete courses can lead to relapse 2
• Do not use antibiotics alone for dental infections without surgical drainage, as this is the most common error leading to treatment failure 3
• Do not extend treatment beyond 7 days for intra-abdominal infections without diagnostic re-evaluation 4

Treatment Response Assessment

• Evaluate clinical response at 72 hours (Day 3) 1, 2
• If no improvement or worsening: switch antibiotics or reevaluate diagnosis 1, 2
• If partial improvement: continue the full course 2
• For sinusitis specifically, 52.4% of patients should show major improvement by Day 3 with standard-dose therapy 6