Azithromycin Dosing for a 19.96 kg Child
For a child weighing 19.96 kg, administer 10 mL (400 mg) of azithromycin 200 mg/5 mL suspension on Day 1, followed by 5 mL (200 mg) once daily on Days 2-5.
Dosing Calculation
The standard pediatric dosing regimen for azithromycin is 10 mg/kg on Day 1, followed by 5 mg/kg once daily on Days 2-5 1, 2.
For this 19.96 kg (approximately 20 kg) child:
Day 1 dose: 10 mg/kg × 20 kg = 200 mg
- Using 200 mg/5 mL suspension: 10 mL (2 teaspoons)
Days 2-5 dose: 5 mg/kg × 20 kg = 100 mg per day
- Using 200 mg/5 mL suspension: 5 mL (1 teaspoon) daily
Total volume for complete 5-day course: 30 mL Total cumulative dose: 600 mg
Clinical Context
This dosing regimen is appropriate for:
- Community-acquired pneumonia caused by atypical pathogens (Mycoplasma pneumoniae, Chlamydophila pneumoniae) 1
- Acute otitis media 2
- Acute bacterial sinusitis 2
The FDA-approved pediatric dosing table confirms that a 20 kg (44 lb) child should receive exactly these volumes when using the 200 mg/5 mL formulation 2.
Alternative Regimens
While the 5-day regimen above is standard, other FDA-approved options exist depending on the indication:
- 3-day regimen: 10 mg/kg once daily for 3 days (10 mL daily for 3 days) - approved for acute otitis media and sinusitis 2
- Single-dose regimen: 30 mg/kg as a single dose (30 mL once) - approved only for acute otitis media 2
However, the 5-day regimen (10 mg/kg Day 1, then 5 mg/kg Days 2-5) remains the preferred approach for most respiratory infections including community-acquired pneumonia 1.
Safety Considerations
This dosing regimen has been extensively studied and is well-tolerated in pediatric patients. Adverse events occur in approximately 7-9% of children, predominantly mild-to-moderate gastrointestinal symptoms 3, 4. The suspension formulation is generally well-accepted by children due to its palatability 3.
Important: Azithromycin can be administered with or without food 2. The suspension should be shaken well before each dose.