Augmentin Dosing for COPD Exacerbation
For adults with COPD exacerbation, take Augmentin (amoxicillin/clavulanic acid) 500 mg/125 mg three times daily (every 8 hours) or 875 mg/125 mg twice daily (every 12 hours) for 5-7 days. 1, 2, 3
Standard Dosing Regimen
The twice-daily 875 mg/125 mg formulation is preferred over the three-times-daily 500 mg/125 mg regimen because it causes significantly less diarrhea while maintaining equal efficacy. 2
Specific Dosing Options:
- First choice: Augmentin 875 mg/125 mg tablet every 12 hours 2
- Alternative: Augmentin 500 mg/125 mg tablet every 8 hours 2
- Duration: 5-7 days total 1, 4, 3
When Antibiotics Are Indicated
Augmentin should be prescribed when you have at least two of the following three cardinal symptoms, with increased sputum purulence being one of them: 1, 5, 4
- Increased dyspnea (shortness of breath)
- Increased sputum volume
- Increased sputum purulence (change to yellow or green color)
Antibiotics reduce short-term mortality by 77%, treatment failure by 53%, and sputum purulence by 44% when appropriately indicated. 4
Treatment Duration Evidence
A 5-7 day course is as effective as longer 10-14 day courses while reducing adverse effects. 4, 6 One high-quality study demonstrated that 3-day treatment can be effective for hospitalized patients who improve after initial therapy, though 5-7 days remains the standard recommendation. 6
The median time to next exacerbation is significantly longer with antibiotic treatment (233 days) compared to placebo (160 days). 3
Important Considerations
Hepatic Impairment:
Patients with liver disease should be dosed with caution and have hepatic function monitored at regular intervals. 2
Concurrent Therapy:
Always combine antibiotics with systemic corticosteroids (prednisone 30-40 mg daily for 5 days) and short-acting bronchodilators during COPD exacerbations. 7, 4
Alternative if Swallowing Difficulty:
Adults who cannot swallow tablets may use the 250 mg/62.5 mg per 5 mL suspension (two teaspoonfuls every 8 hours) or 400 mg/57 mg per 5 mL suspension in place of tablets. 2
Common Pitfalls to Avoid
- Do not extend antibiotic treatment beyond 7 days - this increases adverse effects without additional benefit 4, 6
- Do not use antibiotics for exacerbations with only one cardinal symptom unless that symptom is increased sputum purulence 1, 4
- Do not substitute different Augmentin formulations - the 250 mg/125 mg tablet and 250 mg/62.5 mg chewable tablet contain different amounts of clavulanic acid and are not interchangeable 2