Augmentin 200-28.5 mg/5mL Dosing for 8.89 kg Child
For an 8.89 kg child, administer 4 mL of Augmentin 200-28.5 mg/5mL suspension twice daily (every 12 hours).
Dosing Calculation
The FDA-approved dosing for Augmentin 200-28.5 mg/5mL suspension is based on the amoxicillin component at 45 mg/kg/day divided into 2 doses for standard dosing, or 90 mg/kg/day divided into 2 doses for high-dose therapy 1.
Standard-Dose Regimen (45 mg/kg/day):
- Daily dose: 8.89 kg × 45 mg/kg = 400 mg amoxicillin per day
- Per dose: 400 mg ÷ 2 = 200 mg per dose
- Volume: 200 mg ÷ 40 mg/mL = 5 mL twice daily
High-Dose Regimen (90 mg/kg/day):
- Daily dose: 8.89 kg × 90 mg/kg = 800 mg amoxicillin per day
- Per dose: 800 mg ÷ 2 = 400 mg per dose
- Volume: 400 mg ÷ 40 mg/mL = 10 mL twice daily
When to Use Each Dose
Use standard-dose (5 mL twice daily) for:
- Uncomplicated infections in children ≥2 years
- No recent antibiotic use (within 30 days)
- No daycare attendance
- Areas with low pneumococcal resistance (<10%)
- Mild to moderate severity infections 2
Use high-dose (10 mL twice daily) for:
- Children <2 years old
- Recent antibiotic exposure (within 30 days)
- Daycare attendance
- Areas with high pneumococcal resistance (>10%)
- Moderate to severe infections
- Treatment failures
- Beta-lactamase producing organisms suspected (H. influenzae, M. catarrhalis) 3, 4, 2
Critical Considerations
For beta-lactamase producing organisms, the Augmentin 200-28.5 mg/5mL formulation provides adequate clavulanate coverage at both standard and high doses, as the clavulanate component (28.5 mg/5mL) scales proportionally with the amoxicillin dose 1.
Administration: Give at the start of meals to minimize gastrointestinal side effects and enhance clavulanate absorption 1.
Duration: Typically 7-10 days depending on the infection type. For acute otitis media, 10 days is standard for children <2 years 2.
Common Pitfalls
- Do not substitute different Augmentin formulations interchangeably - the 200-28.5 mg/5mL suspension contains different clavulanate ratios than the 400-57 mg/5mL or ES-600 formulations 1
- Avoid underdosing in high-risk scenarios - children <2 years warrant high-dose therapy due to higher rates of resistant organisms 2
- Shake well before each dose - suspension settles during storage 1
- Refrigerate after reconstitution and discard after 10 days 1