What is the recommended duration of Augmentin (amoxicillin-clavulanate) treatment for an infected bite in a patient?

Treatment Duration for Infected Bite with Augmentin

For an established infected bite, treat with Augmentin (amoxicillin-clavulanate) 875/125 mg twice daily for 7-10 days, with duration determined by clinical response. 1

Recommended Treatment Regimen

First-Line Antibiotic Choice

• Amoxicillin-clavulanate is the first-line antibiotic for bite wounds because it provides coverage for both aerobic and anaerobic bacteria commonly found in bite infections, including Gram-negative organisms (Aeromonas, Vibrio, Enterobacteriaceae) and Gram-positive organisms (Staphylococcus, Streptococcus species). 1

Dosing for Established Infections

• Standard dose: 875/125 mg twice daily for established bite infections 1, 2
• Alternative dose: 500/125 mg twice daily is acceptable for mild to moderate infections 2
• Duration: 7-10 days depending on clinical response 1

Prophylaxis vs. Treatment Distinction

• For prophylaxis in high-risk wounds (not yet infected): 3-5 days of treatment 1
• For established infections (already infected): 7-10 days of treatment 1

Clinical Decision Algorithm

Assess Infection Severity

1. Mild to moderate infection: Use oral Augmentin 875/125 mg twice daily 1
2. Severe infection or sepsis: Consider IV ampicillin-sulbactam 1.5-3.0 g every 6-8 hours, then transition to oral therapy 1

Monitor Treatment Response

• Assess clinical improvement at 3-5 days 3
• If improving: Continue until completion of 7-10 day course 1
• If not improving: Consider broader coverage including MRSA, especially in immunocompromised patients 1

Essential Adjunctive Management

Wound Care

• Thorough wound irrigation and debridement are mandatory first steps before antibiotic therapy 1
• Inadequate wound cleansing is a common pitfall that leads to treatment failure 1

Tetanus Prophylaxis

• Administer tetanus vaccine/toxoid if not up to date within the past 10 years for clean wounds, or within 5 years for dirty wounds 3

Penicillin-Allergic Patients

• Alternative: Doxycycline 100 mg twice daily for 7-10 days 1
• Ensure adequate anaerobic coverage with any alternative regimen to avoid treatment failure 1

Critical Pitfalls to Avoid

Common Errors

• Delaying antibiotic therapy in high-risk or infected wounds leads to poor outcomes 1
• Using antibiotics without adequate anaerobic coverage results in treatment failure 1
• Stopping treatment prematurely before completing 7-10 days increases risk of recurrence and resistance 1
• Inadequate wound irrigation before starting antibiotics compromises treatment success 1

Special Populations

• Immunocompromised patients require more aggressive therapy and closer monitoring 1
• Consider adding MRSA coverage in severe infections or sepsis 1