What is the appropriate Augmentin (amoxicillin/clavulanate) dose for a child weighing 9.25 kg?

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Last updated: October 19, 2026 • View editorial policy

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Augmentin 200-28.5mg/5ml Dosage for 9.25kg Child

For a child weighing 9.25 kg, the appropriate dose of Augmentin 200-28.5mg/5ml suspension is 4.6 mL twice daily (providing approximately 90 mg/kg/day of amoxicillin). This assumes treatment for a condition requiring high-dose amoxicillin-clavulanate, such as acute otitis media with risk factors for resistant pathogens, or community-acquired pneumonia.

Dosing Calculation

The standard high-dose regimen for pediatric infections is 90 mg/kg/day of the amoxicillin component, divided into 2 doses 1.

For a 9.25 kg child:

  • Total daily amoxicillin dose needed: 90 mg/kg/day × 9.25 kg = 832.5 mg/day
  • Per-dose amoxicillin: 832.5 mg ÷ 2 = 416.25 mg per dose
  • Volume per dose: Since the 200-28.5mg/5ml suspension contains 200 mg amoxicillin per 5 mL, each dose requires (416.25 mg ÷ 200 mg) × 5 mL = approximately 10.4 mL twice daily

However, this calculation appears to reference the standard 200-28.5mg/5ml formulation.

Important Clarification on Formulations

Critical distinction: The Augmentin 200-28.5mg/5ml formulation you've specified is NOT interchangeable with Augmentin ES-600 1. The ES-600 formulation contains 600 mg amoxicillin and 42.9 mg clavulanate per 5 mL and is specifically designed for high-dose therapy.

For the 200-28.5mg/5ml suspension at standard dosing (45 mg/kg/day):

  • Daily amoxicillin: 45 mg/kg × 9.25 kg = 416.25 mg/day
  • Per dose (twice daily): 208 mg
  • Volume: 5.2 mL twice daily

For high-dose therapy (90 mg/kg/day) using 200-28.5mg/5ml:

  • Volume: 10.4 mL twice daily

Clinical Context Determines Dosing

Standard-dose (45 mg/kg/day) is appropriate for 2, 3:

  • Uncomplicated community-acquired pneumonia in fully immunized children
  • Simple acute otitis media without risk factors
  • Children ≥2 years without recent antibiotic exposure

High-dose (90 mg/kg/day) is indicated for 2, 3, 4:

  • β-lactamase-producing Haemophilus influenzae or Moraxella catarrhalis
  • Children <2 years old
  • Recent antibiotic exposure (within 30 days)
  • Daycare attendance
  • Moderate-to-severe illness
  • Failed initial amoxicillin therapy

Administration Guidelines

  • Give at the start of meals to minimize gastrointestinal side effects and enhance clavulanate absorption 1
  • Shake suspension well before each dose 1
  • Refrigerate after reconstitution; stable for 10 days 1
  • Duration: Typically 10 days for acute otitis media 1; 5-7 days for uncomplicated pneumonia 5

Common Pitfalls to Avoid

  1. Do not substitute formulations: The 200-28.5mg/5ml and 400-57mg/5ml suspensions contain different clavulanate concentrations and cannot replace ES-600 1

  2. Watch for diarrhea: Protocol-defined diarrhea occurs in 11-13% of children on high-dose therapy 1. The lower clavulanate concentration in newer formulations (2.85-3.2 mg/kg/day vs 6.4 mg/kg/day) reduces this risk without compromising efficacy 6

  3. Verify weight-based dosing: Children at this weight (9.25 kg) typically receive appropriate mg/kg dosing, but larger children often receive subtherapeutic doses when clinicians cap at "adult maximum" doses prematurely 7

  4. Consider local resistance patterns: In areas with high β-lactamase-producing H. influenzae (>10%), amoxicillin-clavulanate is preferred over amoxicillin alone 2, 3

References

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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.