What is the appropriate dosage of Amoxicillin (Amoxicillin) clavulanate (Clavulanate)?

From the Guidelines

Amoxicillin-clavulanate dosing for adults is typically 875 mg amoxicillin/125 mg clavulanate twice daily, as recommended by the most recent guidelines 1. When considering the treatment of various infections, including skin and soft tissue infections, community-acquired pneumonia, and infections following animal or human bites, the dosing of amoxicillin-clavulanate can vary.

• For adults with mild to moderate infections, the standard dose is typically 875 mg amoxicillin/125 mg clavulanate twice daily or 500 mg amoxicillin/125 mg clavulanate three times daily, as seen in the guidelines for community-acquired pneumonia 1.
• The Infectious Diseases Society of America recommends amoxicillin-clavulanate 875/125 mg bid for the treatment of infections following animal or human bites, as outlined in their 2014 practice guidelines 1.
• It's essential to note that treatment duration and dosing may vary depending on the specific condition being treated, patient age, weight, and other factors, such as the presence of comorbidities or risk factors for antibiotic-resistant pathogens.
• The medication should be taken with food to reduce gastrointestinal side effects and improve clavulanate absorption, and the combination of amoxicillin and clavulanate is effective against many bacteria that have developed resistance to amoxicillin alone, including certain strains of Staphylococcus, Haemophilus influenzae, and Escherichia coli.
• The most recent guidelines from 2019 1 provide recommendations for the diagnosis and treatment of adults with community-acquired pneumonia, including the use of amoxicillin-clavulanate as a first-line treatment option.

From the FDA Drug Label

Table 1 ... Ear/Nose/Throat Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours ... For Oral Suspension 125 mg/5 mL ... For Oral Suspension 250 mg/5 mL ...

The recommended dosage for amoxicillin is as follows:

• Mild/Moderate infections: 500 mg every 12 hours or 250 mg every 8 hours for patients 3 months and older and weighing less than 40 kg: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours.
• Severe infections: 875 mg every 12 hours or 500 mg every 8 hours for patients 3 months and older and weighing less than 40 kg: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours. The dosage for amoxicillin clav is not explicitly stated in the provided label, however, the label does provide information on the dosage of amoxicillin alone 2.

From the Research

Amoxicillin Clavulanate Dosage

• The dosage of amoxicillin clavulanate can vary depending on the specific condition being treated and the patient population 3, 4, 5.
• For adults, a common dosage is 875/125 mg every 12 hours or 500/125 mg every 8 hours 4, 5.
• For pediatric patients, the dosage is typically 90/6.4 mg/kg/day in two divided doses 3.
• High-dose formulations, such as 2000/125 mg twice daily, are available for use in adult respiratory tract infections due to drug-resistant pathogens 3.

Efficacy of Different Dosage Regimens

• Studies have shown that dosing amoxicillin clavulanate every 12 hours is as effective as dosing every 8 hours for the treatment of lower respiratory tract infections 4 and acute bacterial maxillary sinusitis 5.
• The efficacy of amoxicillin clavulanate has also been compared to other antibiotics, such as clarithromycin and penicillin V, in the treatment of group A streptococcal tonsillopharyngitis 6.

Safety and Tolerance

• Amoxicillin clavulanate has a well-known safety and tolerance profile, with adverse events related to treatment reported at a similar frequency to other antibiotics 3, 4, 5.
• The safety and tolerance of high-dose formulations of amoxicillin clavulanate are not significantly different from those of conventional formulations 3.