From the Guidelines
For a 24 kg child with acute otitis media, the recommended dose of amoxicillin is 40 mg/kg/day divided into two doses, which equals approximately 960 mg per day or 480 mg twice daily, as per the guidelines from the World Health Organization pocket book of hospital care 1. This dosage is based on the most recent and highest quality study available, which prioritizes the treatment of acute otitis media in children. The typical duration of treatment is 5 days, as recommended by the World Health Organization guidelines 1. It is essential to note that amoxicillin should be given with food to reduce stomach upset, and the liquid formulation should be refrigerated after reconstitution. Parents should complete the full course of antibiotics even if symptoms improve within a few days. If the child develops a rash, severe diarrhea, or shows no improvement after 48-72 hours of treatment, they should contact their healthcare provider, as this may indicate either an allergic reaction or the need for a different antibiotic. Some studies may recommend higher doses of amoxicillin, such as 90 mg/kg/day 1, but the World Health Organization guidelines provide a more conservative and widely accepted approach to treating acute otitis media in children. Key points to consider when treating a 24 kg child with acute otitis media include:
- Using the recommended dose of 40 mg/kg/day divided into two doses
- Completing the full 5-day course of antibiotics
- Monitoring for potential side effects, such as rash or severe diarrhea
- Contacting the healthcare provider if symptoms do not improve within 48-72 hours of treatment.
From the FDA Drug Label
Table 1 ... Ear/Nose/Throat Mild/ Moderate 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours Severe 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours
For a 24 kg child with an acute otitis media (ear infection), the recommended dose of amoxicillin is:
- Mild/Moderate: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours
- Severe: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours Using the weight of the child (24 kg), the dose would be:
- Mild/Moderate: 600 mg/day (25 mg/kg/day x 24 kg) in divided doses every 12 hours or 480 mg/day (20 mg/kg/day x 24 kg) in divided doses every 8 hours
- Severe: 1080 mg/day (45 mg/kg/day x 24 kg) in divided doses every 12 hours or 960 mg/day (40 mg/kg/day x 24 kg) in divided doses every 8 hours 2
From the Research
Amoxicillin Dosage for Ear Infection in a 24 kg Child
- The recommended dose of amoxicillin for a child with an acute otitis media (ear infection) is typically based on the child's weight 3.
- For a 24 kg child, the dose can be calculated based on the recommended dosage of 40 mg/kg/day, divided into three equal doses every 8 hours 3.
- However, some studies suggest that a higher dose of 75 to 90 mg/kg/day may be more effective in eradicating resistant Streptococcus pneumoniae, particularly during viral coinfection 3.
- Another study compared the effectiveness of amoxicillin with alternative agents, such as azithromycin, and found that high-dose amoxicillin (80-90 mg/kg/day) may not be superior to other treatments 4.
- The American Academy of Pediatrics recommends a dose of 80-90 mg/kg/day for children with acute otitis media, but this may need to be adjusted based on the individual child's needs and medical history.
Calculation of Amoxicillin Dosage
- Based on the recommended dosage of 40 mg/kg/day, a 24 kg child would require:
- 24 kg x 40 mg/kg/day = 960 mg/day
- Divided into three equal doses every 8 hours: 960 mg/day / 3 = 320 mg/dose
- However, if a higher dose of 75-90 mg/kg/day is recommended, the calculation would be:
- 24 kg x 75 mg/kg/day = 1800 mg/day
- Divided into three equal doses every 8 hours: 1800 mg/day / 3 = 600 mg/dose
- Or, for a dose of 90 mg/kg/day: 24 kg x 90 mg/kg/day = 2160 mg/day, divided into three equal doses every 8 hours: 2160 mg/day / 3 = 720 mg/dose