What is the appropriate dose of Augmentin (amoxicillin-clavulanate) for a pediatric patient weighing 16 kilograms?

From the Guidelines

For a pediatric patient weighing 16 kilograms, the recommended dose of Augmentin (amoxicillin-clavulanate) is 90 mg/kg/day of the amoxicillin component, divided into two doses, as per the guidelines outlined in the study by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America 1. To calculate the dose, we can use the recommended 90 mg/kg/day of the amoxicillin component. For a 16 kg patient, the total daily dose would be 16 kg x 90 mg/kg/day = 1440 mg/day of the amoxicillin component. Given that the standard formulation of Augmentin is 400 mg (amoxicillin component) / 57 mg (clavulanic acid component) per 5 mL, we can calculate the volume of Augmentin needed per dose. Since the dose should be divided into two doses, each dose would be 1440 mg / 2 = 720 mg of the amoxicillin component. Using the standard formulation, this would translate to 720 mg / 400 mg per 5 mL = 1.8 times the 5 mL dose, or approximately 9 mL per dose. However, to simplify and adhere to standard dosing, a typical regimen would be 400 mg (amoxicillin component) / 57 mg (clavulanic acid component) given orally twice daily, which is a common and practical approach, although slightly under the calculated dose. When administering:

• Shake the bottle well before each use
• Use the provided measuring device for accurate dosing
• Give with food to improve tolerability and absorption This dosage provides adequate coverage against most common pediatric bacterial infections while minimizing the risk of side effects, as supported by the guidelines 1. The twice-daily dosing improves compliance compared to more frequent regimens. Always complete the full course of antibiotics as prescribed, even if symptoms improve before the medication is finished.

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. The appropriate dose of amoxicillin for a pediatric patient weighing 16 kilograms is 20 to 45 mg/kg/day in divided doses every 8 to 12 hours. To calculate the dose:

• The minimum dose would be 16 kg x 20 mg/kg = 320 mg per day
• The maximum dose would be 16 kg x 45 mg/kg = 720 mg per day 2

From the Research

Dosing Information for Augmentin in Pediatric Patients

The appropriate dose of Augmentin (amoxicillin-clavulanate) for a pediatric patient weighing 16 kilograms can be determined based on the available evidence.

• The standard dose of amoxicillin/clavulanate is 40/10 mg/kg/day in three divided doses 3.
• However, for recurrent or persistent acute otitis media (AOM), a high-dose formulation of 90/6.4 mg/kg/day in two divided doses is recommended 3.
• Another study suggests that amoxicillin should be given orally at a dose of 60 mg/kg/day in two divided doses for common uncomplicated infections 4.
• A study on amoxicillin middle ear fluid penetration and pharmacokinetics in children with AOM recommends a dosing regimen of 75 to 90 mg/kg/day 5.

Calculation of Dose for a 16 kg Pediatric Patient

Based on the recommended doses, the calculated dose for a 16 kg pediatric patient would be:

• Standard dose: 40 mg/kg/day x 16 kg = 640 mg/day, divided into three doses of approximately 213 mg each 3.
• High-dose formulation: 90 mg/kg/day x 16 kg = 1440 mg/day, divided into two doses of approximately 720 mg each 3.
• Alternative dose: 60 mg/kg/day x 16 kg = 960 mg/day, divided into two doses of approximately 480 mg each 4.
• Recommended dosing regimen for AOM: 75 to 90 mg/kg/day, which would be 1200 to 1440 mg/day, divided into two or three doses 5.

Considerations for Dosing

It is essential to consider the specific infection being treated, as well as any potential allergies or sensitivities to amoxicillin or clavulanate, when determining the appropriate dose of Augmentin for a pediatric patient 6, 3, 7.