What is the recommended oral Augmentin (amoxicillin-clavulanate) dose for an adult patient with normal renal function and no history of allergy to penicillin or other beta-lactam antibiotics?

Oral Augmentin Dosing for Adults with Normal Renal Function

For adults with normal renal function, the standard oral Augmentin dose is 500 mg/125 mg every 12 hours for mild-to-moderate infections, or 875 mg/125 mg every 12 hours for more severe infections and respiratory tract infections. 1

Standard Dosing Regimens

Mild-to-Moderate Infections

• 500 mg/125 mg tablet every 12 hours is the usual adult dose 1
• Alternative: 250 mg/125 mg tablet every 8 hours 1

Severe Infections and Respiratory Tract Infections

• 875 mg/125 mg tablet every 12 hours is recommended 1
• Alternative: 500 mg/125 mg tablet every 8 hours 1

Critical Administration Guidelines

Timing with Meals

• Administer at the start of a meal to enhance clavulanate absorption and minimize gastrointestinal intolerance 1
• May be taken without regard to meals, but meal administration is preferred 1

Important Formulation Warnings

• Two 250 mg/125 mg tablets cannot substitute for one 500 mg/125 mg tablet because both contain the same amount of clavulanic acid (125 mg), making them non-equivalent 1
• The 250 mg/125 mg tablet and 250 mg/62.5 mg chewable tablet are not interchangeable due to different clavulanic acid content 1

Clinical Evidence Supporting Dosing

Efficacy Data

• The 375 mg three times daily regimen (equivalent to approximately 500 mg/125 mg formulation) demonstrated 85.7% clinical success in urogenital infections when used for 6-12 days 2
• Clinical cure rates of 88.4% were achieved with 1 g amoxicillin plus 200 mg clavulanic acid every 8 hours in serious bacterial infections 3
• The 500 mg amoxicillin + 250 mg clavulanic acid every 8 hours regimen showed "good" clinical response in 77% of lower respiratory tract infections 4

Treatment Duration

• Duration varies by infection type: 6-12 days for urogenital infections 2, minimum 10 days for serious infections 3, and 7 days for respiratory infections 4
• For acute otitis media specifically, 10 days of therapy is recommended 1

Common Pitfalls to Avoid

• Do not substitute tablet strengths based solely on amoxicillin content—clavulanic acid ratios differ and are critical for efficacy 1
• Avoid dosing without food in patients prone to GI upset, as this significantly increases intolerance 1
• Do not underdose severe infections—use the 875 mg/125 mg formulation rather than 500 mg/125 mg for respiratory tract infections and severe disease 1

Special Considerations

• Patients with difficulty swallowing may use oral suspension formulations as alternatives to tablets 1
• The every 12-hour regimen is preferred over every 8-hour dosing as it is associated with significantly less diarrhea 1
• Augmentin is particularly valuable for multiply-resistant bacteria and amoxicillin-resistant organisms, with success rates around 70% for resistant pathogens 5, 6