From the Guidelines
For a child weighing 26kg, the recommended dose of amoxicillin is 90 mg/kg/day in 2 doses, as stated in the guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America 1. This dosage is based on the standard pediatric dosing for community-acquired pneumonia. Using this dosage, the calculation for this child is: 26kg x 90mg/kg/day = 2340mg/day 2340mg/day ÷ 2 doses = 1170mg per dose Since the suspension is typically 400mg/5ml, this translates to approximately 14.6ml per dose (1170mg / 400mg per 5ml = 2.925 * 5ml = 14.6ml). Administer this dose every 12 hours for 7-10 days, or as directed by the prescribing physician. Always complete the full course of antibiotics, even if symptoms improve before the medication is finished. Give the medication with or without food, but try to space doses evenly throughout the day. Shake the bottle well before each use and use a proper measuring device for accurate dosing. Store the medication at room temperature and discard any unused portion after 14 days. Some key points to consider:
- The dosage may vary depending on the specific diagnosis and local susceptibility data 1.
- For children with a history of possible, nonserious allergic reactions to amoxicillin, treatment should be individualized and alternatives considered 1.
- The guidelines recommend completing the full course of antibiotics to minimize the risk of resistance and ensure effective treatment 1.
From the FDA Drug Label
Table 1 ... 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
For a 26kg child, the dose of amoxicillin is:
- Mild/Moderate: 25 mg/kg/day = 650 mg/day, which can be divided into 325 mg every 12 hours or 217 mg every 8 hours
- Severe: 45 mg/kg/day = 1170 mg/day, which can be divided into 585 mg every 12 hours or 390 mg every 8 hours 2
From the Research
Amoxicillin Dosage for a 26kg Child
- The World Health Organization (WHO) recommends oral amoxicillin at a dose of 15 mg/kg of body weight/dose, thrice daily (t.i.d.) for children with ambulatory pneumonia 3.
- For a 26kg child, the calculated dose would be 15 mg/kg * 26 kg = 390 mg per dose, given thrice daily.
- Alternatively, a study suggests that a 30- to 40-mg/kg/dose b.i.d. regimen may be considered to lengthen the time above the MIC at higher concentration levels 3.
- For a 26kg child, the calculated dose would be 30-40 mg/kg * 26 kg = 780-1040 mg per dose, given twice daily.
- Another study recommends high-dose amoxicillin given twice daily for five days for all uncomplicated respiratory infections where an antibiotic is indicated, but does not provide a specific dose for a 26kg child 4.
- A study on the treatment of severe pneumonia in children used a dose of 80-90 mg/kg per day of oral amoxicillin, given in two doses 5.
- For a 26kg child, the calculated dose would be 80-90 mg/kg * 26 kg = 2080-2340 mg per day, given in two doses of 1040-1170 mg each.