Azithromycin Dosing for 11.97 kg Child
For a child weighing 11.97 kg, administer 3 mL (120 mg) of azithromycin 200 mg/5 mL suspension on day 1, followed by 1.5 mL (60 mg) once daily on days 2-5.
Dosing Calculation
The standard pediatric dosing for azithromycin in community-acquired pneumonia and atypical infections is 10 mg/kg on day 1, followed by 5 mg/kg once daily on days 2-5 1.
For this 11.97 kg child:
- Day 1 dose: 11.97 kg × 10 mg/kg = 119.7 mg ≈ 120 mg (3 mL)
- Days 2-5 dose: 11.97 kg × 5 mg/kg = 59.85 mg ≈ 60 mg (1.5 mL)
Using the 200 mg/5 mL suspension (40 mg/mL concentration):
- 120 mg ÷ 40 mg/mL = 3 mL
- 60 mg ÷ 40 mg/mL = 1.5 mL
FDA-Approved Dosing Confirmation
The FDA label confirms this 5-day regimen for pediatric patients, with dosing calculated at 10 mg/kg on day 1 and 5 mg/kg on days 2-5 2. This weight falls within the standard dosing table parameters, and the calculated volumes align with approved pediatric dosing guidelines.
Clinical Context
This dosing regimen is appropriate for:
- Atypical pneumonia (Mycoplasma pneumoniae, Chlamydophila pneumoniae)
- Community-acquired pneumonia (outpatient setting)
- Acute otitis media
- Pharyngitis/tonsillitis (as second-line therapy)
The guidelines emphasize that for children ≥5 years with presumed bacterial pneumonia, azithromycin can be added to β-lactam therapy if atypical pathogens cannot be excluded 1.
Important Caveats
Tolerance limits: The dose of 10 mg/kg falls well within the established tolerance range of 15-30 mg/kg for children in this age group 3. Research confirms that doses in this range are safe and well-tolerated, with gastrointestinal side effects being mild and rarely requiring discontinuation 4.
Alternative regimens exist but are NOT recommended for this weight:
- The 30 mg/kg single-dose regimen (used for acute otitis media) would require 359 mg, which is excessive and primarily studied for specific otitis media protocols 2
- The 3-day regimen at 10 mg/kg daily is less effective than the 5-day regimen for most indications 5
Administration: Azithromycin suspension can be taken with or without food 2. The suspension should be shaken well before each dose.