Augmentin Dosing for Skin Infections
For uncomplicated skin infections in adults, the standard Augmentin dose is 875 mg/125 mg orally every 12 hours, or alternatively 500 mg/125 mg every 8 hours for more severe infections. 1
Adult Dosing
- Standard dose: 500 mg/125 mg tablet every 12 hours for mild to moderate skin infections 1
- More severe infections: 875 mg/125 mg tablet every 12 hours OR 500 mg/125 mg tablet every 8 hours 1
- Duration: Typically 7-10 days depending on clinical response 2
- Administration: Take at the start of meals to enhance clavulanate absorption and minimize gastrointestinal side effects 1
Pediatric Dosing (≥12 weeks/3 months)
- Standard dose: 25 mg/kg/day divided every 12 hours for less severe infections 1
- More severe infections: 45 mg/kg/day divided every 12 hours 1
- Alternative regimen: 40 mg/kg/day divided every 8 hours (though the every 12-hour regimen is preferred due to less diarrhea) 1
- Children ≥40 kg: Use adult dosing recommendations 1
- Neonates <12 weeks: 30 mg/kg/day divided every 12 hours 1
Clinical Context and Indications
Augmentin is specifically recommended for animal and human bite wounds where mixed aerobic-anaerobic flora is expected, including Pasteurella multocida from animal bites 2
Appropriate Use:
- Animal bites: First-line oral agent (875/125 mg twice daily) 2
- Human bites: First-line oral agent (875/125 mg twice daily) 2
- Mixed skin infections: Effective against both gram-positive cocci and some gram-negative organisms 3, 4
- Infected eczema, trauma, or ulcers: Demonstrated 94% response rate in clinical studies 3
Important Limitations:
- Does NOT cover MRSA: If MRSA is suspected or confirmed, alternative agents (vancomycin, linezolid, clindamycin, TMP-SMX, or doxycycline) must be used 2
- Some gram-negative resistance: Certain gram-negative rods may be resistant 2
Critical Dosing Warnings
Do NOT substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet - they contain the same amount of clavulanic acid (125 mg) but different amounts of amoxicillin, making them non-equivalent 1
Do NOT interchange different formulations - the 250 mg/125 mg tablet contains 125 mg clavulanic acid while the 250 mg/62.5 mg chewable contains only 62.5 mg clavulanic acid 1
Renal Function Adjustments
While not explicitly detailed in the provided FDA label excerpt, dose adjustment is required for patients with significant renal impairment (this is standard practice for amoxicillin-clavulanate, though specific adjustments should be referenced from complete prescribing information).
Safety Profile
- Common side effects: Nausea (9%), diarrhea (9%), and rash (3%) 3
- Generally well-tolerated: Adverse events are typically mild to moderate, primarily involving the digestive system 4, 5
- Pregnancy: FDA Category B - generally considered safe 6 (though this refers to cephalexin, similar beta-lactams like amoxicillin-clavulanate are also Category B)
Clinical Efficacy
Augmentin demonstrates 76-94% clinical cure rates for skin and soft tissue infections, with particular effectiveness against Staphylococcus aureus (methicillin-susceptible) and Streptococcus pyogenes 3, 4, 5