Augmentin (amoxicillin/clavulanate potassium) is a widely prescribed, broad-spectrum antibiotic combination indicated for the treatment of diverse bacterial infections. Its formulation integrates amoxicillin, a beta-lactam antibiotic, with clavulanate potassium, a beta-lactamase inhibitor, to extend its efficacy against beta-lactamase-producing bacteria that would otherwise resist amoxicillin alone. This combination enhances its bactericidal activity, making it a first-line option for numerous community-acquired and some hospital-associated infections. It is available in multiple formulations, including oral tablets, chewable tablets, and suspensions, to accommodate both adult and pediatric patients.

Features

• Combination antibiotic: amoxicillin and clavulanate potassium
• Available in immediate-release and extended-release tablets
• Multiple strengths: 250 mg/125 mg, 500 mg/125 mg, 875 mg/125 mg
• Pediatric suspension formulations with varied concentrations
• Bactericidal activity against Gram-positive and Gram-negative organisms
• Effective against beta-lactamase-producing strains of bacteria

Benefits

• Provides broad-spectrum coverage for a wide array of bacterial pathogens
• Overcomes bacterial resistance mechanisms via clavulanate’s inhibition of beta-lactamase enzymes
• Facilitates convenient dosing regimens suitable for outpatient management
• Available in multiple formulations to support adherence across age groups
• Rapid onset of action leading to prompt symptomatic relief when used appropriately
• Well-established safety and efficacy profile supported by extensive clinical use

Common use

Augmentin is commonly prescribed for bacterial infections such as acute bacterial sinusitis, community-acquired pneumonia, acute otitis media, skin and skin structure infections, and urinary tract infections. It is also used in dental infections, animal bite wounds, and lower respiratory tract infections where beta-lactamase-producing organisms are suspected or confirmed. Its broad activity makes it a versatile choice in empirical therapy before culture results are available.

Dosage and direction

Dosage varies based on infection severity, patient age, renal function, and formulation. For adults, typical doses range from 500 mg/125 mg every 12 hours to 875 mg/125 mg every 12 hours for immediate-release tablets. The extended-release formulation (Augmentin XR) is dosed as 2,000 mg/125 mg every 12 hours. Pediatric dosing is weight-based, usually 25–45 mg/kg/day divided every 12 hours, depending on the infection. Administration with food is recommended to enhance absorption and reduce gastrointestinal upset. Always complete the full course as prescribed, even if symptoms improve earlier.

Precautions

Use with caution in patients with hepatic impairment, as clavulanate is metabolized by the liver. Monitor for signs of hepatotoxicity. In patients with renal impairment (CrCl <30 mL/min), dosage adjustment is necessary. Prolonged use may result in fungal or bacterial superinfection, including Clostridioides difficile-associated diarrhea. Avoid in patients with a history of antibiotic-associated colitis. Use during pregnancy only if clearly needed; it is excreted in breast milk. May cause false-positive glucose tests in urine using copper reduction methods.

Contraindications

Augmentin is contraindicated in patients with a history of hypersensitivity to amoxicillin, clavulanate, or any other beta-lactam antibiotics (e.g., penicillins, cephalosporins). It is also contraindicated in patients with a history of Augmentin-associated cholestatic jaundice or hepatic dysfunction. Do not use the extended-release tablets in patients with severe renal impairment (CrCl <30 mL/min) or those on hemodialysis.

Possible side effect

Common side effects include diarrhea, nausea, vomiting, abdominal discomfort, and skin rash. Less frequently, patients may experience headache, dizziness, vaginitis, or transient elevations in liver enzymes. Serious but rare adverse effects include hepatotoxicity, cholestatic jaundice, Stevens-Johnson syndrome, toxic epidermal necrolysis, agranulocytosis, and anaphylaxis. Pseudomembranous colitis has been reported with nearly all antibacterial agents, including Augmentin.

Drug interaction

Probenecid decreases renal tubular secretion of amoxicillin, potentially increasing blood levels. Concurrent use with allopurinol may increase the incidence of skin rashes. Augmentin may reduce the efficacy of oral contraceptives; advise alternative contraception during therapy. It can potentiate the effect of warfarin and other oral anticoagulants, necessitating closer monitoring of INR. Avoid concomitant administration with bacteriostatic antibiotics, as this may reduce Augmentin’s bactericidal effect.

Missed dose

If a dose is missed, take it as soon as remembered, unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Maintaining consistent dosing intervals is important to keep antibiotic concentrations effective against bacteria.

Overdose

Symptoms of overdose may include gastrointestinal disturbances (severe nausea, vomiting, diarrhea) and electrolyte imbalances. In severe cases, renal crystalluria or hematuria may occur. Management is primarily supportive, including correction of fluid and electrolyte imbalances. Hemodialysis may enhance elimination of both amoxicillin and clavulanate.

Storage

Store tablets at room temperature (20–25°C or 68–77°F) in a dry place. Keep the oral suspension refrigerated (2–8°C or 36–46°F) after reconstitution and discard any unused portion after 10 days. Keep all formulations out of reach of children and protected from light and moisture.

Disclaimer

This information is for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a healthcare provider for personalized recommendations based on your health status and specific condition. Do not initiate, adjust, or discontinue medication without medical supervision.

Reviews

Augmentin is highly regarded in clinical practice for its efficacy in treating polymicrobial and resistant infections. Healthcare professionals appreciate its reliability and broad spectrum, though some note gastrointestinal side effects as a drawback. Patient feedback often highlights rapid symptom improvement, though adherence can be challenged by side effects like diarrhea. Overall, it remains a cornerstone antibiotic in both primary care and specialized settings.