Augmentin
Augmentin is a brand-name medication prescribed for specific bacterial infections. It is available as an oral tablet and an oral liquid suspension and belongs to the penicillin class of antibiotics.
Drug contains two active ingredients: amoxicillin and clavulanic acid (as clavulanate potassium). This combination allows Augmentin to target a broader range of bacteria than antibiotics with only amoxicillin.
Uses
Augmentin is frequently used to treat infections in both adults and children, including those affecting the urinary tract, respiratory tract, ears, sinuses, and skin. Some of these applications are FDA-approved, while others are considered off-label. Off-label drug use involves prescribing a medication for a purpose other than its FDA-approved indications.
For Acne
Antibiotic may be used off-label to treat certain types of acne. However, 2024 guidelines from the American Academy of Dermatology do not recommend it as a first-choice treatment for acne.
For Sinusitis (Sinus Infection)
Medication is FDA-approved for treating sinus infections in both adults and children. The 2015 guidelines from the American Academy of Otolaryngology recommend Augmentin as a first-choice medication for sinus infections.
For Ear Infection
Drug is FDA-approved for treating ear infections (otitis media) in both children and adults. However, 2013 guidelines from the American Academy of Pediatrics suggest Augmentin is not usually the first-choice antibiotic for ear infections in children. It is often reserved for children who have recently been treated with another antibiotic like amoxicillin or those with recurring ear infections that were not effectively treated by amoxicillin. Augmentin ES-600 is specifically approved to treat certain ear infections in some children.
For Urinary Tract Infection (UTI)
Medicine is FDA-approved for treating UTIs. According to 2010 guidelines from the Infectious Diseases Society of America (IDSA), Augmentin is not the first-choice antibiotic for UTIs but is used when other medications, such as trimethoprim/sulfamethoxazole, are unsuitable.
For Pneumonia
Augmentin is FDA-approved for treating pneumonia. It is typically recommended in combination with other antibiotics if the patient has underlying conditions such as heart disease, diabetes, liver disease, or kidney disease.
For Strep Throat
Antibiotic is not FDA-approved for treating strep throat (streptococcal pharyngitis). Additionally, 2012 IDSA guidelines do not recommend Augmentin for most cases of strep throat.
For Bronchitis
Medication is approved for treating certain respiratory infections, including some cases of bronchitis. Although bronchitis is often viral and antibiotics are not typically effective, a persistent bacterial infection may be treated with antibiotics such as Amoxicillin.
For Cellulitis
Cellulitis is a type of skin infection. Antibiotic is FDA-approved for treating some skin infections, including cellulitis caused by specific bacteria. However, 2014 IDSA guidelines do not recommend Augmentin as a first-choice antibiotic for cellulitis.
For Diverticulitis
While Augmentin is not FDA-approved for treating diverticulitis, it is sometimes used off-label for this purpose.
Dosage
The dosage of Augmentin prescribed by your doctor will depend on various factors, including:
- The specific form of Augmentin being used
- The type and severity of the infection being treated
- Patient age
- Body weight (particularly in children)
Below is an overview of typical dosages, but always follow the specific dosage prescribed by your healthcare provider, which is tailored to your individual needs.
Forms and Strengths
Augmentin is available in different forms and strengths. The numbers below represent the amount of amoxicillin and clavulanic acid, respectively, in milligrams (mg):
Oral Tablet:
- 875 mg/125 mg
Oral Liquid Suspension:
- 600 mg/42.9 mg per 5 mL
- 250 mg/62.5 mg per 5 mL
- 125 mg/31.25 mg per 5 mL
Adult Dosage Recommendations
Urinary Tract Infections
Severe infections: One 875-mg tablet every 12 hours for 10 to 14 days.
Sinus Infections
Standard dosage: One 875-mg tablet every 12 hours for 5 to 7 days.
Skin Infections (e.g., impetigo)
Standard dosage: One 875-mg tablet every 12 hours for 7 days.
Ear Infections
Standard dosage: One 875-mg tablet every 12 hours for 10 days.
Respiratory Infections (e.g., pneumonia)
Standard dosage: One 875-mg tablet every 12 hours for 10 days.
Alternative Form for Adults
For adults who have difficulty swallowing tablets, Augmentin is also available in a liquid suspension form. The concentration and dosage will be specified by your pharmacist based on the doctor’s prescription.
Pediatric Dosage
For children, Augmentin is typically prescribed in a liquid suspension. The dosage varies based on the child's age, weight, the severity of the infection, and the condition being treated:
Infants Under 3 Months
Dosage: 30 mg/kg/day of amoxicillin, divided into two doses every 12 hours, typically using the 125 mg/5 mL suspension.
Children 3 Months and Older Weighing Under 40 kg
- Less severe infections: 20 mg/kg/day, divided into three doses every 8 hours.
- More severe infections: 40 mg/kg/day, divided into three doses every 8 hours.
Children Weighing 40 kg or More
May use the adult dosage with the oral tablet form.
Missed Dose
If you miss a dose of Augmentin, take it as soon as possible. If it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses as this can lead to adverse effects.
How To Take
Follow your doctor's instructions carefully when taking Augmentin. Even if you start to feel better before completing your treatment, do not stop taking this drug unless your doctor advises it. Completing the entire course of treatment is often crucial to fully eradicate the infection and prevent its recurrence.
Timing
Twice daily: Take tablets approximately 12 hours apart.
Three times daily: Take tablets approximately 8 hours apart.
Taking with Food
With meals: Take Augmentin with a meal to reduce stomach upset and enhance absorption.
Can Pills be Crushed?
Crushing tablets: oral tablets can be crushed. If the tablet is scored (has an indented line), it can be split in half.
Liquid suspension: If you have difficulty swallowing pills, ask your doctor or pharmacist about using Augmentin liquid suspension as an alternative.
Side Effects
Augmentin can cause a range of side effects, from mild to serious. Below are some key side effects that may occur.
Mild and More Common Side Effects
The more common side effects of Amoxicillin include:
- Nausea
- Diarrhea
- Vaginitis (such as yeast infection)
- Skin rash
- Vomiting
Other mild side effects reported in clinical trials include:
- Headache
- Gas
- Abdominal discomfort
These side effects may resolve within a few days to a couple of weeks. If they become severe or persist, contact your doctor or pharmacist.
Serious Side Effects
If you experience serious side effects, contact your doctor immediately. If you believe you are experiencing a medical emergency, call 911.
Serious side effects and their symptoms can include:
Liver Problems
Though uncommon, some people taking Augmentin may develop liver damage, particularly older adults and those on long-term treatment. Usually, these issues resolve after stopping the medication, but they can sometimes be severe and require treatment. Symptoms of liver problems include:
- Abdominal pain
- Yellowing of the skin or whites of the eyes
- Fatigue
Your doctor may perform blood tests to check for liver damage.
Intestinal Infection
Antibiotics, including Augmentin, can lead to an intestinal infection called Clostridioides difficile (C. diff). Symptoms of C. diff infection include:
- Abdominal pain or cramping
- Severe diarrhea that doesn’t go away
- Blood in the stool
- Nausea
Severe Skin Reactions
Augmentin can cause serious skin reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). Symptoms of severe skin reactions include:
- Blisters and skin peeling
- Red or discolored skin rash
- Flu-like symptoms
- Fever
Drug-Induced Enterocolitis Syndrome (DIES)
Amoxicillin, one of Augmentin's active ingredients, can cause DIES, an allergic reaction affecting the digestive system. This is more common in children than adults. Symptoms of DIES include:
- Diarrhea
- Prolonged vomiting
- Pale skin
- Low blood pressure
- Sluggishness
- Elevated white blood cell levels
- Shock
Allergic Reaction
Serious allergic reactions can occur, especially in individuals with a penicillin allergy. Symptoms include:
- Swelling of the lips, tongue, throat
- Severe skin rash
- Trouble breathing
- Hives
If you have previously had a serious allergic reaction to Augmentin or other penicillins, you should not take this medication again as it could be fatal.
Alternatives
Various antibiotics can treat the same conditions as Augmentin, and some may be more suitable for you based on your age, infection type and severity, previous treatments, and local bacterial resistance patterns.
For Urinary Tract Infections (UTIs):
- Bactrim
- Cipro
For Sinus Infections:
- Amoxil
- Doxycycline
For Skin Infections:
- Doxycycline
- Cleocin
For Ear Infections:
- Amoxil
For Pneumonia:
- Zithromax
- Doxycycline
- Amoxil
Alcohol
Drinking alcohol while taking Augmentin can increase the risk of certain side effects or exacerbate existing ones. Some side effects that might be more likely to occur or worsen with alcohol use include:
- Liver problems
- Dizziness
- Vomiting
- Upset stomach
Pregnancy and Breastfeeding
The effects of Amoxicillin during pregnancy have not been thoroughly studied in humans. While animal studies have shown no harm to the fetus, these results do not always predict human outcomes. Therefore, Augmentin should only be used during pregnancy if there is a clear and necessary reason.
Amoxicillin is known to pass into breast milk in small amounts. While generally considered safe for use during breastfeeding, it may cause side effects in the breastfed child. If you are breastfeeding, consult your doctor before taking Augmentin.