What is the recommended dosage of Augmentin (amoxicillin/clavulanic acid) for a 9 kg child with a resistant ear infection?

From the Guidelines

For a 9 kg child with a resistant ear infection, the recommended dosage of Augmentin (amoxicillin/clavulanic acid) is 80-90 mg/kg/day of the amoxicillin component, divided into two doses, as recommended by the most recent guidelines 1. This translates to approximately 720-810 mg of amoxicillin per day, divided into two doses of 360-405 mg, for this child. The high-dose formulation is preferred for resistant infections, such as Augmentin ES-600, which provides more amoxicillin while maintaining the same amount of clavulanic acid to minimize gastrointestinal side effects. Key considerations for the treatment include:

• The treatment duration should be 10 days to ensure complete eradication of the infection, as shorter courses may lead to treatment failure or the development of resistance 1.
• The medication should be given with food to reduce stomach upset, and the full course must be completed even if symptoms improve before the medication is finished.
• This higher dosage is effective against resistant strains because it maintains antibiotic concentrations above the minimum inhibitory concentration for a longer period, allowing better penetration into the middle ear fluid and more effective killing of resistant bacteria, particularly beta-lactamase producing organisms that the clavulanic acid component helps overcome 1. It is essential to note that the choice of antibiotic and dosage may vary depending on the specific circumstances of the infection, including the severity of the infection, the presence of any underlying medical conditions, and the likelihood of resistance to certain antibiotics. In general, the use of high-dose amoxicillin-clavulanate is recommended for children with moderate to severe illness, those younger than 2 years, attending child care, or who have recently been treated with an antimicrobial agent 1. The potassium clavulanate levels in Augmentin are adequate to inhibit all β-lactamase–producing H influenzae and M catarrhalis, making it an effective choice for the treatment of resistant ear infections 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Recommended Dosage of Augmentin for Resistant Ear Infection

The recommended dosage of Augmentin (amoxicillin/clavulanic acid) for a 9 kg child with a resistant ear infection is as follows:

• For children with resistant ear infections, a high-dose formulation of amoxicillin/clavulanic acid (90/6.4 mg/kg/day in two divided doses) is recommended 2, 3, 4
• This dosage is based on studies that have shown the efficacy of high-dose amoxicillin/clavulanic acid in treating resistant ear infections in children 5, 2, 3, 4

Calculation of Dosage for a 9 kg Child

To calculate the dosage for a 9 kg child, the following formula can be used:

• 90 mg/kg/day x 9 kg = 810 mg/day
• Divide the total daily dose by 2 to get the dose per administration: 810 mg/day ÷ 2 = 405 mg per dose
• The dose per administration is 405 mg of amoxicillin and 28.8 mg of clavulanic acid (based on a 90/6.4 mg/kg/day ratio)

Administration Schedule

The recommended administration schedule for Augmentin in children with resistant ear infections is:

• Twice daily, with 12 hours between doses 2, 6
• The dose should be taken at the same time every day to maintain consistent drug levels in the body

Important Considerations

• The dosage and administration schedule may vary depending on the specific formulation of Augmentin being used and the individual child's needs 2, 3, 4
• It is essential to follow the recommended dosage and administration schedule to ensure the effectiveness of the treatment and minimize the risk of adverse effects 5, 2, 3, 4, 6