Augmentin Dosing for Lymphadenitis in Adults
For uncomplicated acute bacterial lymphadenitis in adults with normal renal function, use Augmentin 875 mg/125 mg orally every 12 hours for 7-10 days, taken at the start of meals to enhance absorption and minimize gastrointestinal side effects. 1
Dosing Rationale
The standard adult dosing for bacterial soft tissue infections follows FDA-approved regimens:
- Standard dose: 500 mg/125 mg every 12 hours OR 250 mg/125 mg every 8 hours 1
- For more severe infections or respiratory involvement: 875 mg/125 mg every 12 hours OR 500 mg/125 mg every 8 hours 1
Since lymphadenitis represents a soft tissue infection that may involve deeper structures, the higher-dose regimen (875 mg/125 mg every 12 hours) is preferred to ensure adequate tissue penetration and coverage of resistant organisms 1, 2.
Treatment Duration
- Typical course: 7-10 days is appropriate for most uncomplicated bacterial lymphadenitis 3
- Continue treatment until clinical improvement is evident (reduction in lymph node size, tenderness, and systemic symptoms) 4
- Some sources suggest continuing antibiotics for 7 days after the patient is clinically well to ensure complete eradication 3
Administration Guidelines
Critical administration point: Augmentin should be taken at the start of a meal 1. This timing:
Clinical Monitoring
Assess response within 3-5 days of initiating therapy 3:
- If improving: Continue the same regimen until completion 3
- If no improvement or worsening: Consider switching to an alternative agent with broader coverage (such as a respiratory fluoroquinolone) or re-evaluate for complications 3
Important Caveats
Do not substitute formulations: Two 250 mg/125 mg tablets are NOT equivalent to one 500 mg/125 mg tablet, as both contain the same amount of clavulanic acid (125 mg) 1. Using two lower-dose tablets would result in excessive clavulanate and increased risk of diarrhea.
Resistance considerations: Augmentin provides excellent coverage for beta-lactamase-producing organisms commonly implicated in lymphadenitis, including Staphylococcus aureus (methicillin-sensitive) and Streptococcus species 2. Recent evidence confirms non-inferiority of narrower-spectrum agents in pediatric lymphadenitis, but Augmentin remains the standard empiric choice in adults 4.
Renal adjustment: The dosing above applies only to patients with normal renal function; dose reduction is required for creatinine clearance <30 mL/min 1.