From the Guidelines
The recommended dosage of Amoxicillin for otitis media is 80-90 mg/kg/day [ 1 ].
Dosage Details
- This dosage should be divided into two or three doses [ 1 ].
- The treatment duration is typically 5-7 days in children [ 1 ].
- For adults, the recommended dosage is 500-875 mg, two or three times a day, for 5-7 days [ 1 ].
Special Considerations
- In severe cases, the dose may be increased to 90 mg/kg/day in children [ 1 ].
- For patients allergic to amoxicillin, alternative treatments such as cefdinir, cefuroxime, or ceftriaxone may be considered [ 1 ].
- It is essential to complete the full course of treatment to ensure effective resolution of the infection [ 1 ].
Key Points
- Amoxicillin is recommended as first-line therapy for AOM because it is generally effective when used in sufficient doses against susceptible and intermediate resistant pneumococci [ 1 ].
- The choice of a first-line treatment should be based on the anticipated clinical response and the microbiologic flora likely to be present [ 1 ].
From the FDA Drug Label
Table 1 ... Ear/Nose/Throat Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours Severe 875 mg every 12 hours or 500 mg every 8 hours 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours
The recommended dosage of Amoxicillin for otitis media (Ear/Nose/Throat infection) is:
- Mild/Moderate: 500 mg every 12 hours or 250 mg every 8 hours for patients 3 months and older and weight greater than or equal to 40 kg, or 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours for patients 3 months and older and weight less than 40 kg.
- Severe: 875 mg every 12 hours or 500 mg every 8 hours for patients 3 months and older and weight greater than or equal to 40 kg, or 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours for patients 3 months and older and weight less than 40 kg 2
From the Research
Recommended Dosage of Amoxicillin for Otitis Media
The recommended dosage of amoxicillin for otitis media varies depending on the study.
- A study published in 1998 3 recommends a dosing regimen of 75 to 90 mg/kg/day for AOM.
- A study published in 2010 4 found that primary care physicians prescribe a significantly lower-than-recommended amoxicillin dose in older children and those in the higher weight category.
- The American Academy of Pediatrics recommends use of high-dose amoxicillin for the treatment of acute uncomplicated OM, with a dose of 80 to 90 mg/kg per day 4, 5.
- A study published in 2000 6 compared the efficacy and safety of amoxycillin/clavulanate twice daily versus three times daily in the treatment of acute otitis media in children, with a dose of 45/6.4 mg/kg/day twice-daily.
Factors Affecting Dosage
Several factors can affect the dosage of amoxicillin for otitis media, including:
- Weight: Children weighing 20 kg or less may require higher doses of amoxicillin 4.
- Age: Children under 2 years may require different treatment approaches than older children 5.
- Presence of viral coinfection: Amoxicillin MEF penetration tends to be lower in children with viral infection 3.
Treatment Approaches
Different treatment approaches may be recommended depending on the severity of symptoms and the presence of allergies or other conditions.
- High-dose amoxicillin (80 to 90 mg per kg per day) is the antibiotic of choice for treating acute otitis media in patients who are not allergic to penicillin 5.
- Amoxicillin/clavulanate may be used as a second-line agent for children with persistent symptoms despite 48 to 72 hours of antibiotic therapy 5.