How long to see results from Augmentin?

[Wombat140]

I'm three weeks into a course of co-amoxiclav (Augmentin) and tinidazole. There hasn't been any improvement so far. Currently taking 750 mg of co-amoxiclav a day (in three doses), but the prescription says to cut it to 500 mg when it gets to four weeks. Is four weeks long enough to be sure whether it's going to work or not? If not, is it really a good idea to cut the dose before it starts to work?

 

Is 750 mg a high enough dose anyway (given I've had these symptoms for years)? When I say 750 mg, I mean 750 mg amoxicillin, with 375 mg clavulanic acid.

 

Confused. Don't want to blow it.

[croatian mum]

my son had also symptoms for years (6 year priod the diagnisis); he is now in a flare and he is taking 2 grams of Augmentin daily for the last 8 days. Also no improvement so far; (and I also wanated to write a post about it) but the things is - he is 12yo; and on 2 grams split in 2 doses; so I belive it is possible for You to give a higher dose to Your son.

[Wombat140]

It's me taking it. Thanks very much for the reply! Is that slow-release or normal Augmentin? I've heard you can give higher doses with slow-release.

How much does your son weigh, by the way? I only weigh 42 kilos so I'm never quite sure where that leaves things.

[bigmighty]

My son weighs 49 kilos/108 pounds - age 14. He was placed on Augmentin 875 2x daily a year ago (weighed quite a bit less at that time). It wasn't until two months after the completion of a 21 day steroid taper that he began to see remission of symptoms. He has been in remission for nearly nine months. He was recently changed to a lower dose of antibiotics - Augmentin 500 2x daily. I don't think everyone achieves remission through antibiotics alone.

[colleenrn]

Are you taking a total of 750mg of Augmentin per day or are you taking 750mg three times each day??

[MomWithOCDSon]

Are you taking a total of 750mg of Augmentin per day or are you taking 750mg three times each day??

 

I'll echo colleern. Are you dosing once a day or three times a day at what equates to (if I read your first post correctly), 1,125 mg. of Augmentin (amoxi/clav combined)?

 

For comparison's sake, my DS, ages 12 through 14 and 110 to 135 lbs., took 2,000 mg. daily of Augmentin XR (extended release) in 1,000 dosages, 2x daily. However, according to the PDR, Augmentin XR is dosed at 4,000 mg. daily for adults with conditions such as sinus infections, etc. So even if you are dosing the 1,125 mg. 3x per day, you would still be below that 4,000 mg. mark.

[Wombat140]

Yes, sorry - I'm taking 750 mg of amoxicillin i.e. 1125 mg total of Augmentin a day. Each pill has 250 mg amox. and 125 mg clav. and I'm on three a day, but supposed to reduce to two a day next week.

 

It's the time thing that really bothers me, can anyone advise? Is three weeks really enough that I'd have seen an effect by then if there's going to be one? If not, does it really make sense to reduce the dose before any effect's visible? I'm going to e-mail the doctor, but I'd like to have some idea what I'm talking about by the time I get a reply!

Many thanks

Wombat140

Edited January 10, 2013 by Wombat140

[colleenrn]

The dosing for children by body weight for Augmentin is 20mg/kg/day- 40mg/kg/day.

 

If you weigh 42 kg(92.4 lb.)then you are currently only getting the lowest dose (20mg/kg/day). If you dropped it to only 500mg/day, you would be getting only 12mg/kg/day which is a tiny dose. I would actually be taking more than that now. You could take 500mg three times a day (which would work out to be about 35mg/kg/day). See what your dr says.

Edited January 10, 2013 by colleenrn

[MomWithOCDSon]

Wombat --

 

Again, sort of again ponying-on to what colleenrn has said, it seems to me you can't necessarily judge the effectiveness of the med at this point because, based on your math, her math and mine, you haven't actually received a "treatment" dose yet!

 

In our experience (with a younger person who'd suffered for a shorter time period than you but was -- from the sound of it anyway -- only about 1/4 as functional at the time) -- the treatment-sized dose of 2,000 mg. of Augmentin XR per day had visible results within a miraculously short time: 48 hours for us. It didn't immediately reverse all of the behaviors or OCD, but it boosted his functioning enough that he could come down out of his room and sit at the dinner table with his dad and me for the first time in nearly 4 months! Those sorts of "leaps and bounds" in healing kept up for about 2 weeks, after which point the healing trajectory slowed down, sometimes plateaued, sometimes crept almost imperceptably, for a while. After 4 months or so, it took some close, careful journaling for us to continue to map the improvements because they were increasingly subtle, but still occurring.

 

I would 1) talk to my doctor about a treatment dose of the Augmentin, and 2)engage in some daily journaling to chart how I'm feeling, what's still bugging me, what seems to have loosened its grip a bit, etc. In fact, if you live with a loved one who's helping you on this journey, it might be even more helpful to ask them if they'll do a little journaling in observation of you as time goes on. Doesn't have to be long or fancy . . . just a few words about what they're noticing in your aspect, behavior, what changes (if any), however subtle. I don't know that my DS would have been successful, especially in the beginning, of taking note of how many OCD behaviors and rituals he was beginning to shed, but from the outside looking in, it was pretty obvious to his dad and me.

 

Good luck!

[croatian mum]

My son is 12; 42 kilos; and dr. K told us to give him Augmentin; 2 x 875 mg. We here don't have pills in this doses; so I give him Augmentin 1000 mg in the morning; and 1000 at the evening. Not Xr augmentin.

[Wombat140]

Thanks for telling me, all of you. I've asked the doctor whether he'd consider increasing the dose, since there hasn't been an improvement yet. Rather hoping he will, after what you've said. No answer yet, it always takes a few days to get hold of him because of course he's up to his ears with work. I think maybe he only said to reduce the dose because he'd expected results to start before then.

 

Colleenrn - are you talking about total dose of co-amoxiclav there, or dose of amoxicillin? I was quoting in amoxicillin - I'm taking 1,125 mg total co-amoxiclav, and the dose I'm supposed to reduce to would be 750 mg co-amoxiclav.

 

I'll have another crack at keeping a note of symptoms, and I'll ask Mum too. I did it for a while when I started the azithromycin, and then things got so bad it fell by the wayside. Was just getting too depressing. The improvements were the most depressing part, because the next week I'd have to write down that they'd gone... Ah this is a dog's life. I'm just the skivvy for a bunch of tics. Anyhow, since it seems you can go a lot higher dose than that, maybe that'll crack it. It had better, since it's still proving impossible to get a needle into me. ( 1: nerves 2: tics.) I suppose steroids also possible, that's pills, isn't it?

 

Mum wants to know whether, if any of you have started out with an insufficient dose and had to increase, you noticed any results at all on the lower dose, or whether it's likely that you wouldn't notice any difference until you got to whatever turned out to be the dose you needed?

Thanks very much.

Wombat140

[MomWithOCDSon]

Mum wants to know whether, if any of you have started out with an insufficient dose and had to increase, you noticed any results at all on the lower dose, or whether it's likely that you wouldn't notice any difference until you got to whatever turned out to be the dose you needed?

Thanks very much.

Wombat140

 

Sorry, never started out at a lower dose and increased, so nothing to report there.

 

However, we DID try, on several occasions, to lower the dosage. By Day 8 after lowering, DS's behaviors would get noticably worse again, so we would have to take the dosage back up to where it's been before. It would be about 4 or 5 days before the "backward slide" would cease , and then another week or so before we could document any new, noticable improvements.

 

Not quite the same thing, but similar, I would think.

[Wombat140]

Thanks Nancy. That kind of suggests that it should only take 4-5 days to see an effect - but then maybe he was "almost there" on the lower dose anyway, and things only needed pushing a bit further? Anyway, I e-mailed the doctor on Thursday so surely there should be a reply soon - fingers crossed.

Anyone know how long it takes before you can be sure it's not working? Or whether no results at all at a low dose can still just mean you need a higher dose?