What is the appropriate dose of amoxicillin for a pediatric patient weighing 14 kg, to be administered twice daily for 10 days, given a formulation of 400 mg per 5 mL?

From the Guidelines

For a 14 kg child requiring amoxicillin, I recommend administering 280 mg twice daily for 10 days. This dose is calculated based on the standard pediatric dosing of 20 mg/kg/dose twice daily, as suggested by 1. Since the child weighs 14 kg, the appropriate dose is 14 kg × 20 mg/kg = 280 mg per dose. Given that the amoxicillin suspension concentration is 400 mg per 5 mL, each dose would require 3.5 mL of the suspension (280 mg ÷ 400 mg × 5 mL = 3.5 mL).

• The caregiver should administer 3.5 mL of the amoxicillin suspension to the child twice daily, with doses spaced approximately 12 hours apart, for a total of 10 days.
• It's essential to complete the full course of antibiotics even if symptoms improve before the 10 days are finished, as stated in 1 and 1.
• This dosing regimen ensures adequate blood levels of the antibiotic to effectively treat bacterial infections while minimizing side effects.
• The treatment duration of 10 days is in line with the recommendations for pneumococcal pneumonia, as mentioned in 1.
• It is crucial to assess therapeutic efficacy after 2 or 3 days of treatment and consider hospitalization if no improvement is observed or if the general condition worsens, as suggested in 1.

From the FDA Drug Label

In Pediatric Patients over 3 Months of Age, 20 to 45 mg/kg/day in divided doses every 8 to 12 hours.

To calculate the pediatric amoxicillin dose for a child weighing 14 kg, we need to determine the dose per day and then divide it by the number of doses per day.

• The recommended dose is 20 to 45 mg/kg/day.
• For a child weighing 14 kg, the dose would be:
  • Minimum dose: 14 kg x 20 mg/kg/day = 280 mg/day
  • Maximum dose: 14 kg x 45 mg/day = 630 mg/day
• Since the child will be taking the medication twice daily, we divide the daily dose by 2:
  • Minimum dose: 280 mg/day / 2 = 140 mg/dose
  • Maximum dose: 630 mg/day / 2 = 315 mg/dose
• The amoxicillin 400 per five indicates that there are 400 mg of amoxicillin in 5 mL of suspension.
• To determine the volume of suspension per dose, we can use the minimum and maximum doses:
  • Minimum dose: 140 mg / 400 mg per 5 mL = 1.75 mL (approximately)
  • Maximum dose: 315 mg / 400 mg per 5 mL = 3.94 mL (approximately)
• For 10 days, the child would need:
  • Minimum dose: 1.75 mL/dose x 2 doses/day x 10 days = 35 mL
  • Maximum dose: 3.94 mL/dose x 2 doses/day x 10 days = 78.8 mL Given the provided dosing information, a suitable dose for the child could be around 1.75 mL to 3.94 mL of the amoxicillin suspension per dose, twice daily, for 10 days 2.

From the Research

Pediatric Amoxicillin Dosage Calculation

To calculate the pediatric amoxicillin dosage for a child weighing 14 kg, we need to consider the recommended dosage of 80-90 mg/kg/d, as stated in the study 3.

• The child's weight is 14 kg.
• The recommended dosage is 80-90 mg/kg/d.
• Since the child needs to take the medication twice daily for 10 days, we will calculate the total daily dose and then divide it by 2 to get the dose per administration.
• Total daily dose: 14 kg * 80 mg/kg/d = 1120 mg/d (using the lower end of the recommended range)
• Total daily dose: 14 kg * 90 mg/kg/d = 1260 mg/d (using the upper end of the recommended range)
• Dose per administration (twice daily): 1120 mg/d / 2 = 560 mg per dose (using the lower end of the recommended range)
• Dose per administration (twice daily): 1260 mg/d / 2 = 630 mg per dose (using the upper end of the recommended range)

Comparison with Available Formulations

The available formulation is amoxicillin 400 per 5 (assuming 5 mL).

• To achieve the calculated dose, we need to determine how many mL of the formulation the child should take.
• Using the lower end of the recommended range (560 mg per dose): 560 mg / 400 mg per 5 mL = 7 mL per dose
• Using the upper end of the recommended range (630 mg per dose): 630 mg / 400 mg per 5 mL = 7.875 mL per dose

Please note that these calculations are based on the provided study 3 and may not be directly applicable to the specific situation without considering other factors, such as the child's medical history and current health status. Additionally, the other studies 4, 5, 6, 7 do not provide relevant information for calculating pediatric amoxicillin dosage.