From the Guidelines
For a 65-pound (29.5 kg) 10-year-old male with an ear infection, the recommended amoxicillin dose at 90 mg/kg/day would be 2,655 mg per day, divided into two doses, as supported by the American Academy of Pediatrics and American Academy of Family Physicians guideline 1. This dose is based on the guideline's recommendation of 80 to 90 mg per kg per day for amoxicillin treatment of acute otitis media, which is effective against susceptible and intermediate resistant pneumococci 1. The calculated dose of 2,655 mg per day can be approximated to 1,325 mg twice daily for practical administration. Some possible administration options include:
- 500 mg tablets: 1,500 mg per day (750 mg twice daily)
- 250 mg/5mL suspension: 15 mL of the suspension twice daily The treatment duration should typically be 10 days for complete eradication of the infection, as the optimal duration of therapy for patients with AOM is uncertain 1. It is essential to ensure the child completes the full course even if symptoms improve earlier. If the child has a penicillin allergy or doesn't improve within 48-72 hours, alternative antibiotics such as cefdinir, cefpodoxime, or cefuroxime should be considered, as recommended by the guideline 1.
From the FDA Drug Label
Table 1 ... Ear/Nose/Throat Mild/ Moderate 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours Severe 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours
The recommended dose for a 65-pound (approximately 29.5 kg) 10-year-old male with an ear infection is not 90 mg/kg/day. For a mild to moderate ear infection, the dose would be 25 mg/kg/day, and for a severe infection, the dose would be 45 mg/kg/day. To calculate the dose:
- Mild to moderate: 25 mg/kg/day * 29.5 kg = 737.5 mg/day
- Severe: 45 mg/kg/day * 29.5 kg = 1327.5 mg/day Given in divided doses every 12 hours, the dose would be approximately 369 mg every 12 hours for mild to moderate infections, or 664 mg every 12 hours for severe infections 2.
From the Research
Amoxicillin Dosage for Ear Infection
To calculate the amoxicillin dose for a 65-pound, 10-year-old male with an ear infection at 90mg/kg/day, we need to first convert the weight from pounds to kilograms.
- 1 pound is equal to 0.453592 kilograms
- 65 pounds is equal to 65 * 0.453592 = 29.48348 kilograms
Calculating Amoxicillin Dosage
The recommended dosage is 90mg/kg/day.
- For a 29.48348 kilogram child, the dosage would be 90 * 29.48348 = 2653.51232 milligrams per day
- This can be rounded to approximately 2654 milligrams per day
Relevant Studies
There are no direct studies provided that discuss the specific dosage of 90mg/kg/day for amoxicillin in the treatment of ear infections in children. However, studies such as 3 discuss the importance of weight-based dosing for amoxicillin in the treatment of acute otitis media, highlighting the need for high-dose amoxicillin (80 to 90 mg/kg per day) as recommended by the American Academy of Pediatrics.
- The study 3 also notes that primary care physicians often prescribe lower-than-recommended doses, especially in older or heavier children.
- Other studies like 4, 5, and 6 compare the efficacy of different antibiotics, including amoxicillin, in the treatment of acute otitis media, but do not specifically address the dosage calculation based on weight.
- Study 7 discusses the anti-inflammatory effects of various macrolide antibiotics but does not provide information on amoxicillin dosing.