What is the appropriate Amoxicillin (amox) dose for a 65-pound male with Acute Otitis Media?

From the Guidelines

For acute otitis media in a 65-pound (29.5 kg) male, I recommend amoxicillin at a dose of 80 to 90 mg per kg per day, as suggested by the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) 1.

Key Considerations

• The dosage is based on extrapolation from microbiologic studies and expert opinion, with the preponderance of benefit over risk 1.
• 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 optimal duration of therapy for patients with AOM is uncertain, but a common duration is 10 days.

Calculation of Amoxicillin Dosage

• For a 65-pound (29.5 kg) male, the amoxicillin dosage would be: 29.5 kg x 80 to 90 mg/kg/day = 2360 to 2655 mg per day.
• This can be divided into two doses per day, resulting in approximately 1180 to 1327.5 mg twice daily.

Additional Recommendations

• Ensure the full course is completed even if symptoms improve within a few days.
• If symptoms worsen after 48-72 hours or fail to improve after 3-5 days, the patient should be reevaluated.
• Common side effects include diarrhea and rash.
• The medication should be stored at room temperature and can be taken with food to minimize stomach upset.

From the Research

Amoxicillin Dosage for Acute Otitis Media

To determine the appropriate amoxicillin dosage for a 65-pound male with acute otitis media, we need to consider the recommended dosage ranges.

• The American Academy of Pediatrics recommends high-dose amoxicillin (80-90 mg/kg/d) for the treatment of acute otitis media 2.
• A study published in the Journal of Family Practice suggests that high-dose amoxicillin (80-90 mg/kg/d) remains the drug of choice for treatment of acute otitis media despite increasing antimicrobial resistance 2.
• Another study published in the Annals of Pharmacotherapy compared the efficacy and tolerability of high-dose versus standard-dose amoxicillin among children with acute otitis media and found that high-dose amoxicillin did not result in a greater incidence of adverse effects than standard-dose amoxicillin 3.

Calculating the Dosage

Based on the recommended dosage range of 80-90 mg/kg/d, we can calculate the dosage for a 65-pound male.

• First, we need to convert the weight from pounds to kilograms: 65 pounds / 2.2 pounds/kilogram = approximately 29.5 kilograms.
• Then, we can calculate the dosage: 80-90 mg/kg/d * 29.5 kg = 2360-2655 mg/d.
• This dosage can be divided into two doses per day, as recommended by the studies.

Summary of Findings

In summary, the recommended amoxicillin dosage for a 65-pound male with acute otitis media is 2360-2655 mg/d, divided into two doses per day 2, 3. It is essential to note that the dosage may vary depending on the specific circumstances and the presence of any underlying medical conditions. Other studies have compared the efficacy of amoxicillin with other antibiotics, such as azithromycin 4, 5, and clarithromycin 4, but these are not directly relevant to determining the appropriate dosage for this patient. Additionally, a study published in Pediatrics found that the prevalence of nonsusceptible Streptococcus pneumoniae (NSSP) and nonsusceptible to standard-dose amoxicillin (NSSP-A) can vary by community, which may impact the choice of antibiotic and dosage 6.