What is the recommended dose of amoxyclav (amoxicillin and clavulanic acid) 625 mg tablets for an adult patient with normal renal function?

Amoxyclav 625 mg Dosing for Adults

For adults with normal renal function, the standard dose of amoxyclav 625 mg (500 mg amoxicillin/125 mg clavulanic acid) is one tablet three times daily (every 8 hours) for most respiratory and soft tissue infections. 1

Standard Dosing Regimen

• The recommended dose is 625 mg three times daily (TDS) orally for 5-14 days depending on the infection type 2, 1
• Treatment duration varies by indication: 5-7 days for acute bacterial sinusitis, 7-10 days for non-severe pneumonia, and 10-14 days for bronchiectasis exacerbations 1
• This dosing provides adequate coverage for beta-lactamase producing organisms including Haemophilus influenzae, Moraxella catarrhalis, and methicillin-sensitive Staphylococcus aureus 2, 1

Clinical Applications by Infection Type

Respiratory Tract Infections

• For community-acquired pneumonia (non-severe, outpatient): 625 mg three times daily for 7-10 days 2, 3
• For acute bacterial sinusitis without risk factors: 625 mg three times daily for 5-7 days 2, 1
• For bronchiectasis exacerbations: 625 mg three times daily for 14 days 1

When to Use Higher Doses

• Patients with risk factors for resistant organisms require high-dose therapy: 2000 mg/125 mg twice daily instead of standard 625 mg dosing 1
• Risk factors include: recent antibiotic use (within 4-6 weeks), treatment failure, moderate-to-severe disease, age >65 years, immunocompromised status, or areas with >10% penicillin-resistant Streptococcus pneumoniae prevalence 1

Administration Guidelines

• Tablets should be taken at the start of meals to minimize gastrointestinal side effects and optimize absorption 4
• The 625 mg formulation contains a fixed 125 mg dose of clavulanic acid to minimize diarrhea while maintaining efficacy 1
• Switch from intravenous to oral formulation as soon as clinically appropriate 2

Common Pitfalls to Avoid

• Do not reduce dosing frequency to twice daily with the 625 mg formulation—this dose requires three-times-daily administration for adequate coverage 2, 1
• Avoid prescribing 625 mg for patients with recent antibiotic exposure or severe infections; these require high-dose formulations 1
• Do not continue therapy beyond 7 days for uncomplicated respiratory infections without reassessment, as prolonged courses increase resistance risk 1
• If no improvement occurs after 72 hours, consider changing antibiotics or reevaluating the diagnosis rather than simply extending treatment duration 1

Monitoring and Reassessment

• Clinical response should be evident within 48-72 hours of initiating therapy 5
• Gastrointestinal adverse effects (primarily diarrhea) occur in approximately 6% of patients but are generally mild 3, 5
• Treatment failure rates with standard-dose amoxyclav are 20-25% when risk factors for resistant organisms are present, necessitating high-dose therapy in these populations 1