What volume of Augmentin (amoxicillin/clavulanate) oral suspension is needed to deliver a 200 mg amoxicillin dose for a 2‑year‑old child weighing 12.9 kg?

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Augmentin Dosing Calculation for 2-Year-Old, 12.9 kg

To deliver a 200 mg amoxicillin dose using standard Augmentin oral suspension (200 mg/5 mL formulation), administer 5 mL of the suspension.

Dosing Calculation

For a 12.9 kg child requiring 200 mg of amoxicillin:

  • Augmentin 200 mg/5 mL suspension contains 200 mg amoxicillin per 5 mL
  • Volume needed: 5 mL delivers exactly 200 mg amoxicillin
  • This also provides 28.5 mg clavulanate per 5 mL dose

Context and Considerations

Standard Pediatric Dosing Ranges

The 200 mg dose (approximately 15.5 mg/kg for this child) falls within acceptable ranges for mild-to-moderate infections 1. However, dosing should be matched to the specific infection being treated:

  • Mild infections: 20-40 mg/kg/day divided BID or TID (standard-dose)
  • Moderate-to-severe infections or resistant organisms: 80-90 mg/kg/day divided BID (high-dose) 2, 3, 1

For this 12.9 kg child:

  • Standard dosing: 258-516 mg/day (129-258 mg per dose if BID)
  • High-dose: 1032-1161 mg/day (516-580 mg per dose if BID)

Important Formulation Warning

Do NOT substitute different Augmentin formulations as they contain different clavulanate concentrations 1:

  • 200 mg/5 mL suspension: 28.5 mg clavulanate per 5 mL
  • 400 mg/5 mL suspension: 57 mg clavulanate per 5 mL
  • ES-600 suspension: 42.9 mg clavulanate per 5 mL

These are not interchangeable due to varying clavulanate content.

Administration Guidelines

  • Give at the start of meals to minimize GI intolerance and enhance clavulanate absorption 1
  • Shake suspension well before each use
  • Reconstituted suspension stable for 10 days refrigerated 1

Clinical Pitfall

A single 200 mg dose appears to be underdosing for most pediatric infections. Verify the intended indication:

  • If treating acute otitis media, sinusitis, or pneumonia with concern for resistant S. pneumoniae, this child should receive high-dose therapy: 580 mg (14.5 mL) twice daily 3, 1
  • If treating mild skin/soft tissue infection or uncomplicated UTI, standard dosing of 250-300 mg (6.25-7.5 mL) twice or three times daily is more appropriate

References

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.