Amoxicillin clavulanate is an antibiotic that eliminates bacteria that cause infections such as pneumonia, ear infections, bronchitis, sinusitis, urinary tract infections, and certain skin infections.
Amoxicillin clavulanate is available by prescription as tablets or an oral suspension. It is sold under the brand names Augmentin and Augmentin XR, among others, and is also available as generic amoxicillin and clavulanate potassium.
Treatment should always be managed by a healthcare provider, who will determine the appropriate dose and duration based on the specific condition being treated.
How it works
This medicine combines amoxicillin, which kills susceptible bacteria, with clavulanate, also called clavulanic acid or clavulanate potassium, which blocks bacterial enzymes that can inactivate amoxicillin.
By inhibiting these enzymes, clavulanate helps prevent resistance and improves amoxicillin’s effectiveness.
Indications for use
Amoxicillin clavulanate is indicated for bacterial infections, including:
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Pneumonia or bronchopneumonia;
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Acute or chronic bronchitis;
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Otitis media;
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Pharyngitis or tonsillitis;
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Skin and soft-tissue infections such as boils, abscesses, or infected wounds;
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Infected diabetic foot wounds;
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Urinary tract infections, including cystitis, urethritis, or pyelonephritis;
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Bone and joint infections such as osteomyelitis.
Dentists may also prescribe amoxicillin clavulanate to treat dental infections.
Treatment should always be supervised by a healthcare provider, with the dose and duration adjusted to match the specific infection being treated.
Dosing instructions
Take amoxicillin clavulanate by mouth with a full glass of water and with a light, non-fatty meal to improve tolerance.
Take it at the same times each day and for the full course prescribed, even if symptoms improve sooner. Stopping early can increase the risk of resistant infection.
1. Tablets
Swallow tablets whole without splitting or chewing, because the coating helps reduce stomach irritation. Tablets can be used by adults and by children 12 years and older. Common adult regimens include:
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500 mg/125 mg tablets: 1 tablet every 8 hours;
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875 mg/125 mg tablets: 1 tablet every 12 hours.
The total duration depends on the infection and should be determined by the prescribing provider.
2. Oral suspension
The 200 mg/28.5 mg per 5 mL oral suspension can be used by adults and by children.
The dose of amoxicillin clavulanate oral suspension depends on the type of infection being treated and is calculated based on body weight (in mg per kilogram per day). The total daily dose is then divided into two doses, taken every 12 hours.
Typical daily ranges include:
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Mild to moderate infections (such as tonsillitis, lower respiratory tract infections, or skin infections): 25/3.6 mg to 45/6.4 mg per kg per day, divided every 12 hours;
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Severe infections (such as acute otitis media or acute bacterial sinusitis in children, or bronchopneumonia or urinary tract infections): use high-dose regimens of 80 to 90 mg per kg per day of the amoxicillin component divided every 12 hours, while keeping the clavulanate dose at or below 10 mg per kg per day.
For infants from birth to 12 weeks of age, dosing is typically 30 mg per kg per day based on the amoxicillin component, divided every 12 hours, with careful medical supervision.
For infants older than 12 weeks and children, the pediatrician adjusts the dose by weight and age to reduce the risk of kidney-related adverse effects.
Preparing the suspension
The oral suspension is supplied as a powder and must be reconstituted before use. Use filtered water and the dosing syringe provided to add water to the bottle up to the mark indicated on the label. Shake vigorously to mix well.
Store the prepared suspension in the refrigerator. Depending on the manufacturer, the refrigerated shelf life is 7 to 10 days. Discard any unused suspension after that time.
Shake well before each dose and use the supplied dosing device to measure the correct amount.
Missed doses
If you forget a dose, take it as soon as you remember. Then adjust your schedule based on the time you took the missed dose and continue treatment at the new times.
Do not take a double dose to make up for a missed one.
Side effects
Common side effects can include nausea, vomiting, diarrhea, abdominal pain, itching, skin redness or small blisters, vaginal yeast infection, or vaginal discharge.
Amoxicillin clavulanate can cause serious allergic reactions that require immediate medical attention. Stop the medicine and go to the nearest emergency department if you develop symptoms such as trouble breathing, cough, chest pain, a tight throat sensation, swelling of the mouth, tongue, or face, or hives.
Seek urgent medical care as well if you take more than prescribed and develop symptoms of overdose such as nausea, vomiting, stomach pain, diarrhea, severe skin blistering, unusual sleepiness, agitation, hyperactivity, or decreased urination.
Tell your healthcare provider right away if you experience severe stomach pain, watery or bloody diarrhea, pale or yellow skin, dark urine, fever, confusion or weakness, loss of appetite, little or no urine, unusual bruising, or bleeding.
Contraindications for use
Amoxicillin clavulanate may be used during pregnancy if clearly needed. If you become pregnant during treatment, contact your OBGYN or midwife to discuss risks and benefits. During breastfeeding, small amounts pass into breast milk; nursing is generally acceptable, but monitor the infant for rash, diarrhea, or thrush and inform your pediatrician if symptoms occur.
Do not use amoxicillin clavulanate if you have a known allergy to amoxicillin, clavulanate, or other beta-lactam antibiotics, including penicillins such as penicillin G benzathine and ampicillin, or cephalosporins such as cefuroxime, cefdinir, or cefprozil. It is also contraindicated in anyone with a history of cholestatic jaundice or hepatic dysfunction associated with prior amoxicillin clavulanate use.
People with kidney impairment, including those on hemodialysis, or with liver disease such as hepatic insufficiency or hepatitis should use this medication only under medical supervision, as dose adjustments may be necessary.
Use in neonates and young infants requires medical oversight; dosing from birth to 12 weeks is 30 mg per kg per day based on the amoxicillin component, divided every 12 hours.
Certain medicines can interact with amoxicillin clavulanate. Allopurinol and probenecid can increase the risk of side effects. Anticoagulants such as warfarin may require closer monitoring, and mycophenolate mofetil exposure may be reduced, so monitoring is advised.
Non-rifamycin antibiotics like amoxicillin clavulanate do not routinely reduce the effectiveness of combined hormonal contraceptives; however, vomiting or severe diarrhea may affect absorption, so consider a backup method if gastrointestinal symptoms occur.