My husbands big toe is swollen a great deal and he has been taking augmentin, (amoxicillin and clavulanate) ibuprofen and allopurinol for at least 4 days but nothing has helped what could help?

Get x-ray: There may be some underlying problem that is not being recognized. If it is gout, he needs to be on Indocin (indomethacin) or colchicine, as Allopurinol is not for an acute attack. Talk to your doctor about what he thinks the problem is and to get him on the correct medicine.

A good : History and physical exam will go a long way in figuring out what the problem is. Was there any trauma, any break in skin. Has this happened before. Where does the source of problem appear to be, joint, toenail etc. Do you have fever or chills? Often times if it is the joint, a joint aspiration with joint fluid analysis will differentiate gout vs. Infection. X-rays are also most likely needed.

Gout vs infection: You need to have him see a rheumatologist to aspirate the toe and see if it is gout, infection or both. Without a diagnosis treatment is blind.

Steroids: A swollen big toe is usually gout, although it could be an infection. Sounds like he is treated appropriately for both but may need his joint tapped to see if it is really gout. If so then steroid injection. If infected then IV antibiotics.

Indocin (indomethacin) : I would see your husbands doctor and ask him to discontinue Ibuprofen and start your husband on Indocin (indomethacin) 50mg three times a day for one week. However, make sure your husband does not have any stomach ulcers or heart conditions. Also steriod injections along with drainage of the joint works if indeed he has gout. Make sure he has been tested for uric acid in his blood test. Colchicine works as well.

An examination.: He may have an infection of the joint along with gout.

History?: Did your husband injure his toe? Does he have a history of gout or a laceration. It's unwise to shotgun medication therapy without a reasonable diagnosis. See a podiatrist for an evaluation. X-rays and possibly lab work will indicate whether her should be treating gout, infection or simple pain from trauma or inflammation. Taking all three only exposes him to more possible medication complications.