Dosage for Augmentin 125 mg Suspension
For a 5-year-old child weighing 19 kg, the standard dose of Augmentin (amoxicillin/clavulanate) 125 mg suspension is 45 mg/kg/day of the amoxicillin component, divided into 2 or 3 doses, which equals approximately 855 mg/day total (roughly 7 mL of the 125 mg/5 mL suspension three times daily).
Dosing Framework
The appropriate dose depends critically on:
- Infection severity and type
- Local resistance patterns
- Recent antibiotic exposure
- Daycare attendance
Standard-Dose Regimen (Mild Infections)
For uncomplicated infections in children ≥2 years without recent antibiotic use or daycare attendance:
- 45 mg/kg/day of amoxicillin component divided into 2-3 doses
- For 19 kg child: 855 mg/day total (approximately 285 mg three times daily)
- Using 125 mg/5 mL suspension: ~11.4 mL/day (approximately 3.8 mL three times daily or 5.7 mL twice daily)
This applies to mild respiratory infections where β-lactamase-producing organisms are not suspected 1.
High-Dose Regimen (Moderate-Severe Infections)
For children <2 years, in daycare, with recent antibiotic exposure, or moderate-severe illness:
- 90 mg/kg/day of amoxicillin component divided into 2 doses
- For 19 kg child: 1,710 mg/day total (855 mg twice daily)
- This requires the higher-strength formulation (Augmentin ES-600 or 400 mg/5 mL suspension), as the 125 mg/5 mL formulation would require impractically large volumes 1, 2
Critical Formulation Considerations
The 125 mg/5 mL suspension is NOT appropriate for high-dose therapy. The FDA label explicitly warns that different Augmentin suspensions contain varying amounts of clavulanic acid and are not interchangeable 2.
For β-lactamase-producing Haemophilus influenzae (common in respiratory infections):
- Amoxicillin/clavulanate is preferred over amoxicillin alone
- The clavulanate component (45 mg/kg/day in standard dosing, 6.4 mg/kg/day in high-dose) inhibits β-lactamase 3, 4, 3
Infection-Specific Guidance
Acute Otitis Media or Sinusitis
- Standard dose (45 mg/kg/day): Children ≥2 years, no risk factors 1
- High dose (90 mg/kg/day): Children <2 years, daycare, recent antibiotics, or treatment failure 1, 2
Community-Acquired Pneumonia
- For suspected H. influenzae (β-lactamase producing): Use amoxicillin/clavulanate
- Dosing: 45 mg/kg/day in 3 doses OR 90 mg/kg/day in 2 doses if β-lactamase producing 4
Acute Bacterial Sinusitis
Recent evidence shows no difference in treatment failure between amoxicillin/clavulanate and amoxicillin alone, but amoxicillin/clavulanate carries higher risk of gastrointestinal adverse events (RR 1.15) and yeast infections (RR 1.33) 5. Consider amoxicillin alone for uncomplicated cases.
Common Pitfalls
Volume miscalculation: The 125 mg/5 mL suspension requires large volumes for adequate dosing in older/heavier children—consider switching to higher-strength formulations
Interchangeability error: Different Augmentin suspensions have different clavulanate ratios and cannot be substituted for each other 2
Overuse for viral infections: Amoxicillin/clavulanate should be avoided in viral syndromes to prevent resistance selection 6
Timing with meals: Administer at the start of meals to minimize gastrointestinal intolerance and enhance clavulanate absorption 2
Refrigeration: Once reconstituted, suspension must be refrigerated and is stable for 10 days only 2