What is the recommended dose and duration of Augmentin (amoxicillin-clavulanate) for an adult patient with a superficial skin infection and no known allergies to penicillins?

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Augmentin Dosing for Superficial Skin Infections in Adults

For an adult with a superficial skin infection, prescribe Augmentin 875 mg/125 mg twice daily for 7-10 days. 1, 2

Standard Dosing Regimen

  • The FDA-approved dose for skin and soft tissue infections is 875 mg/125 mg twice daily, which provides optimal coverage for the most common pathogens in superficial skin infections including Staphylococcus aureus and Streptococcus pyogenes. 2

  • The Infectious Diseases Society of America specifically recommends the 875 mg/125 mg twice-daily formulation for standard skin and soft tissue infections, which has demonstrated clinical success rates of 91.5-93%. 1

  • An alternative regimen is 500 mg/125 mg three times daily, though the twice-daily dosing is preferred as it is associated with significantly less diarrhea (1% vs 2%, p<0.05) compared to three-times-daily dosing. 1

Treatment Duration

  • The standard duration is 7-10 days, with 7 days being appropriate for uncomplicated superficial infections that show clinical improvement. 1

  • Treatment should continue until the patient has been afebrile for 48 hours and is clinically stable. 1

Administration Guidelines

  • Administer Augmentin at the start of a meal to enhance absorption of clavulanate and minimize gastrointestinal intolerance. 2

  • The medication may be taken without regard to meals, but taking it with food significantly reduces side effects. 2

Critical Dosing Pitfalls to Avoid

  • Never substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet, as this results in excessive clavulanate dosing (250 mg vs 125 mg) and increases the risk of gastrointestinal side effects. 1, 2

  • Do not use the 500 mg/125 mg twice-daily regimen for superficial skin infections—this lower dose is reserved only for mild infections or animal/human bites. 1

When to Consider Alternative Antibiotics

  • If there is concern for MRSA (purulent drainage, systemic signs, history of MRSA colonization, injection drug use, or failed initial therapy), do not use Augmentin—instead use trimethoprim-sulfamethoxazole, doxycycline, or clindamycin. 3

  • For penicillin-allergic patients without immediate hypersensitivity, consider cephalexin 500 mg four times daily for 7-10 days as an alternative. 3

References

Guideline

Amoxiclav Dosing Guidelines for Adults

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Cephalexin Dosing for Adult Skin Infections

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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