What is the appropriate Augmentin (amoxicillin/clavulanate) dose for a 115‑lb (≈52 kg) patient with normal renal and hepatic function?

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Augmentin Dosing for a 115 lb (52 kg) Patient

For a 115 lb (52 kg) adult patient with normal renal and hepatic function, prescribe Augmentin 875 mg/125 mg every 12 hours for respiratory tract infections or more severe infections, or 500 mg/125 mg every 8 hours as an alternative regimen. 1

Standard Adult Dosing

  • The usual adult dose is 500 mg/125 mg every 12 hours or 250 mg/125 mg every 8 hours for mild to moderate infections. 1

  • For more severe infections and respiratory tract infections, the dose should be 875 mg/125 mg every 12 hours or 500 mg/125 mg every 8 hours. 1

  • The 115 lb patient qualifies for standard adult dosing since pediatric dosing applies only to patients weighing less than 40 kg (88 lb), and this patient weighs 52 kg. 1

Administration Guidance

  • Administer Augmentin at the start of a meal to enhance absorption of clavulanate and minimize gastrointestinal intolerance. 1

  • The medication may be taken without regard to meals, but taking it with food significantly reduces the risk of nausea and diarrhea. 1

Critical Dosing Considerations

  • Never substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet, as both contain the same amount of clavulanic acid (125 mg) and are not equivalent. 1

  • The clavulanic acid component is fixed at 125 mg per dose in adult tablets to avoid tolerability issues, particularly gastrointestinal side effects. 2

Infection-Specific Recommendations

  • For urinary tract infections in adults, a dose of 375 mg (equivalent to one 250 mg/125 mg tablet) three times daily has shown approximately 70% success rates, though current FDA labeling supports higher doses. 3, 4

  • For respiratory infections including sinusitis and lower respiratory tract infections, the higher dose regimen (875 mg/125 mg every 12 hours) is preferred to achieve adequate pharmacodynamic targets. 1, 5

Duration of Therapy

  • Treatment duration typically ranges from 7-10 days for most infections, though this should be tailored to clinical response. 6, 3

  • For urinary tract infections, 6-12 days of therapy has been studied, with most patients showing clinical improvement by day 6-7. 3

Common Prescribing Pitfalls to Avoid

  • Do not use pediatric weight-based dosing (mg/kg/day) for patients weighing ≥40 kg; use standard adult tablet formulations instead. 1

  • Avoid prescribing the 250 mg/125 mg tablet and the 250 mg/62.5 mg chewable tablet interchangeably, as they contain different amounts of clavulanic acid and are not equivalent. 1

  • Do not empirically use amoxicillin/clavulanate for infections likely caused by ESBL-producing organisms without culture data, as this may select for resistance. 2

Monitoring and Tolerability

  • The most common adverse effects are gastrointestinal, including diarrhea and nausea, which occur less frequently with the every-12-hour regimen compared to every-8-hour dosing. 1

  • Patients generally tolerate the medication well when taken with food, with minimal side effects reported in clinical trials. 3, 4

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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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