From the Guidelines
The maximum daily dose of amoxicillin for pediatric patients with otitis media is 90 mg/kg/day. This dosage is based on the recommendation from the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) 1. The dosage of 80 to 90 mg per kg per day is considered optimal for treating acute otitis media, as it is effective against susceptible and intermediate resistant pneumococci. Some key points to consider when administering amoxicillin to pediatric patients with otitis media include:
- The dosage should be divided into two or three doses per day to maintain adequate drug concentrations in the middle ear fluid.
- The total daily dose should not exceed 4000 mg per day.
- It is essential to confirm the child's accurate weight to ensure proper dosing.
- The full prescribed course should be completed, even if symptoms improve quickly, to prevent the development of resistant organisms.
- Potential side effects, such as diarrhea or allergic reactions, should be monitored closely. According to the guideline, 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.
From the Research
Amoxicillin Dosage for Pediatric Patients with Otitis Media
- The maximum amoxicillin dose per day for pediatric patients with otitis media is 80-90 mg/kg/day 2, 3.
- This dosage is recommended for the treatment of acute otitis media (AOM) in children, especially in cases where drug-resistant bacteria are a concern 2, 3.
- However, it's worth noting that primary care physicians may prescribe lower-than-recommended doses, especially for older children and those in higher weight categories 4.
- The American Academy of Pediatrics recommends using high-dose amoxicillin for the treatment of acute uncomplicated OM, but the impact of obesity on this recommendation is not well-discussed 4.
Considerations for Amoxicillin Dosage
- The dosage of amoxicillin should be based on the child's weight, with a maximum dose of 80-90 mg/kg/day 2, 3.
- Some studies suggest that twice-daily dosing of amoxicillin may be as effective as three times daily dosing, and may improve treatment adherence 5.
- The choice of amoxicillin dosage and frequency should be based on the individual child's needs and medical history, as well as the severity of the otitis media infection 2, 3, 5.