Augmentin 250-62.5mg/5ml Dosing for 18.23kg Child
For a child weighing 18.23 kg, administer 7.5 mL of Augmentin 250-62.5mg/5mL suspension twice daily (every 12 hours) for standard-dose therapy, or 13.5 mL twice daily for high-dose therapy if treating resistant pneumococcal infections or severe disease. 1
Dosing Calculation
The appropriate dose depends on the indication and severity:
Standard-Dose Therapy (45 mg/kg/day)
- Calculation: 18.23 kg × 45 mg/kg/day = 820 mg/day ÷ 2 doses = 410 mg per dose
- Volume: 410 mg ÷ 50 mg/mL = 8.2 mL per dose (round to 8 mL practically)
- Indications: Mild-to-moderate infections in children ≥2 years without recent antibiotic exposure or daycare attendance 2, 3
High-Dose Therapy (80-90 mg/kg/day)
- Calculation: 18.23 kg × 90 mg/kg/day = 1,641 mg/day ÷ 2 doses = 820 mg per dose
- Volume: 820 mg ÷ 50 mg/mL = 16.4 mL per dose (round to 16 mL practically)
- Indications: Moderate-to-severe infections, age <2 years, daycare attendance, recent antibiotic use, or high local pneumococcal resistance 2, 3
Clinical Context for Dosing Decision
Choose high-dose therapy (80-90 mg/kg/day) if:
- Treating community-acquired pneumonia or acute bacterial sinusitis with suspected resistant S. pneumoniae 2, 3
- Child attends daycare
- Recent antibiotic exposure within 30 days
- Age <2 years
- Moderate-to-severe illness presentation
- Local pneumococcal resistance >10% 3
Choose standard-dose therapy (45 mg/kg/day) if:
- Mild-to-moderate infection
- Age ≥2 years
- No recent antibiotic exposure
- No daycare attendance
- Low local resistance patterns 3
Important Caveats
⚠️ Critical limitation: The 250-62.5mg/5mL formulation provides only 50 mg amoxicillin per mL. For high-dose therapy (90 mg/kg/day), this child would require 16 mL per dose, which is a large volume that may affect adherence. Consider using the 400-57mg/5mL formulation (80 mg/mL) if available, which would require only 10 mL per dose for high-dose therapy.
⚠️ Do not substitute formulations: Different Augmentin suspensions contain varying amounts of clavulanate and are NOT interchangeable 1. The 250-62.5mg/5mL contains 12.5 mg clavulanate per mL.
Administration: Give at the start of meals to minimize gastrointestinal side effects and enhance clavulanate absorption 1. Shake suspension well before each dose.
Duration: Treat for 10 days for most infections, though this is the best-studied duration rather than necessarily the minimum effective duration 2. Certain pathogens like CA-MRSA may require longer courses 2.