Augmentin 875/125 mg Dosing Recommendation
For an adult patient with normal renal function and no penicillin allergy, Augmentin 875/125 mg should be dosed at one tablet twice daily (every 12 hours) for 7-10 days, depending on the specific infection being treated. 1, 2
Standard Dosing Regimen
The 875/125 mg formulation is specifically designed for twice-daily dosing and is the preferred regimen for respiratory tract infections, skin and soft tissue infections, and urinary tract infections in adults 1, 2
The FDA-approved dosing demonstrates comparable efficacy between 875/125 mg every 12 hours versus 500/125 mg every 8 hours, with significantly less severe diarrhea (1% vs 2%, p<0.05) in the twice-daily regimen 2
Treatment Duration by Indication
Respiratory Tract Infections
- Acute bacterial rhinosinusitis: 10-14 days 1, 3
- Community-acquired pneumonia: 7-10 days (typically 5-7 days if afebrile for 48 hours and clinically stable) 1
- Acute exacerbations of chronic bronchitis: 5-7 days 1, 4
Skin and Soft Tissue Infections
- Standard infections: 7-10 days at 875/125 mg twice daily 1
- Animal or human bites: 5-7 days at 500/125 mg twice daily (note the lower dose for this specific indication) 1
Dental Infections
- Acute dentoalveolar abscess: 5-7 days as adjunctive therapy only after surgical drainage 5
- Critical caveat: Never prescribe antibiotics without addressing the source surgically - this is the most common error leading to treatment failure 5
Key Clinical Considerations
Do not substitute two 250 mg tablets for one 500 mg tablet, as this results in excessive clavulanate dosing and increased gastrointestinal side effects 1
The 875/125 mg twice-daily regimen is preferred over 500/125 mg three-times-daily because it reduces clavulanate-related GI toxicity while maintaining equivalent antimicrobial coverage 1, 2
Assess clinical response at 72 hours (3 days) - if no improvement or worsening occurs, consider switching to an alternative antibiotic or reevaluating the diagnosis 3
When to Consider Alternative Dosing
High-dose regimen (2000/125 mg twice daily) should be reserved for moderate-to-severe respiratory infections, recent antibiotic use within 4-6 weeks, or suspected resistant organisms (particularly penicillin-resistant Streptococcus pneumoniae) 1, 3, 6
For patients requiring three-times-daily dosing (if clinically indicated), use 500/125 mg three times daily instead of 875/125 mg to avoid excessive clavulanate exposure 1
Common Pitfalls to Avoid
Do not use 5-day courses with standard 875/125 mg dosing - this is only appropriate for high-dose regimens (2000/125 mg) in specific respiratory infections 1
Complete the full course of therapy to prevent treatment failure, resistance development, and complications - this is crucial even if symptoms improve early 1
For streptococcal pharyngitis, use plain amoxicillin or penicillin V as first-line, not Augmentin, unless treating chronic carriers with recurrent symptomatic episodes 1