From the Guidelines
For a 3-year-old child weighing 41 pounds (approximately 18.6 kg) with periorbital cellulitis, the recommended dosage of Augmentin (amoxicillin-clavulanate) liquid is 45 mg/kg/day of the amoxicillin component, divided into two doses given every 12 hours, as recommended by the most recent and highest quality study 1. This translates to approximately 400-450 mg of amoxicillin twice daily. The most appropriate formulation would be Augmentin ES-600 (600 mg amoxicillin/42.9 mg clavulanate per 5 mL), with a dose of 7.5 mL twice daily for 10 days. It's essential to note that the dosage may vary depending on the severity of the infection and the presence of any underlying medical conditions.
Some key points to consider when treating periorbital cellulitis with Augmentin include:
- The medication should be given with food to minimize gastrointestinal side effects.
- It's crucial to refrigerate the medication after reconstitution and shake well before each use.
- The full course of treatment should be completed, even if symptoms improve, to ensure the infection is fully cleared.
- Periorbital cellulitis is a serious infection that requires prompt treatment with appropriate antibiotics.
- Augmentin is effective because it combines amoxicillin with clavulanate, which inhibits beta-lactamase enzymes that can cause resistance to amoxicillin alone.
- This combination provides coverage against many common bacteria that cause periorbital cellulitis, including Staphylococcus aureus, Streptococcus species, and Haemophilus influenzae, as supported by studies such as 1 and 1.
In terms of specific dosing guidelines, the following table from 1 provides a useful reference:
| Antibiotics | Dose and frequency | Maximum dose |
|---|---|---|
| Amoxicillin | 90 mg/kg/day PO divided q8-12 h | 4000 mg/day |
| Amoxicillin/clavulanate | Amoxicillin 90 mg/kg/day PO divided q6-8 h | 4000 mg/day |
It's also important to consider the potential for antibiotic resistance and to choose an antibiotic that is effective against the most likely causative pathogens, as discussed in 1 and 1.
From the FDA Drug Label
Based on the amoxicillin component, amoxicillin and clavulanate potassium should be dosed as follows: Patients Aged 12 weeks (3 months) and Older: See dosing regimens provided in Table 1. Table 1: Dosing in Patients Aged 12 weeks (3 months) and Older INFECTION | DOSING REGIMEN | Every 12 hours Otitis media, sinusitis, lower respiratory tract infections, and more severe infections | 45 mg/kg/day every 12 hours Less severe infections | 25 mg/kg/day every 12 hours Patients Weighing 40 kg or More: Pediatric patients weighing 40 kg or more should be dosed according to adult recommendations
The recommended dosing of Augmentin (amoxicillin-clavulanate) liquid for a 3-year-old child with periorbital cellulitis weighing 41 pounds is:
- Since the child weighs more than 40 kg, the adult dosing recommendations should be followed.
- For more severe infections, the dose should be one 875 mg/125 mg amoxicillin and clavulanate potassium tablet every 12 hours or one 500 mg/125 mg amoxicillin and clavulanate potassium tablet every 8 hours.
- The liquid formulation can be used, with the 200 mg/28.5 mg per 5 mL or 400 mg/57 mg per 5 mL suspension used in place of the 875 mg/125 mg tablet, and the 125 mg/31.25 mg per 5 mL or 250 mg/62.5 mg per 5 mL suspension used in place of the 500 mg/125 mg tablet.
- The dose for the child can be calculated based on the adult dose, but it is recommended to use the pediatric dosing regimen for children weighing less than 40 kg, which is 45 mg/kg/day every 12 hours for more severe infections.
- For a child weighing 41 pounds (approximately 18.6 kg), the dose would be approximately 837 mg per day, which can be divided into two doses of 418.5 mg every 12 hours.
- Using the 200 mg/28.5 mg per 5 mL suspension, the dose would be approximately 29.5 mL per day, divided into two doses of 14.75 mL every 12 hours.
- Using the 400 mg/57 mg per 5 mL suspension, the dose would be approximately 14.75 mL per day, divided into two doses of 7.375 mL every 12 hours 2
From the Research
Recommended Dosing of Augmentin for Periorbital Cellulitis
The recommended dosing of Augmentin (amoxicillin-clavulanate) liquid for a 3-year-old child with periorbital cellulitis weighing 41 pounds can be determined based on the available evidence.
- The American Academy of Pediatrics recommends a dose of 45 mg/kg/day of amoxicillin-clavulanate in two divided doses for the treatment of periorbital cellulitis 3.
- For a child weighing 41 pounds (approximately 18.6 kg), the calculated dose would be approximately 837 mg/day, which can be divided into two doses of about 418.5 mg every 12 hours.
- However, it is essential to consult with a pediatrician or a qualified healthcare professional to determine the most appropriate dose and treatment regimen for the specific case, as the severity of the infection and the presence of any underlying medical conditions may require adjustments to the dosage.
Considerations for Treatment
- Periorbital cellulitis is a serious infection that requires prompt and effective treatment to prevent complications and promote recovery 4, 5.
- Amoxicillin-clavulanate is a commonly used antibiotic for the treatment of periorbital cellulitis, especially in cases where the infection is suspected to be caused by beta-lactamase-producing organisms 6, 7.
- The choice of antibiotic and the duration of treatment should be guided by the severity of the infection, the presence of any underlying medical conditions, and the results of microbiological tests, if available.
Important Notes
- The treatment of periorbital cellulitis should be individualized and guided by a qualified healthcare professional.
- The dosage and treatment regimen may need to be adjusted based on the severity of the infection, the presence of any underlying medical conditions, and the response to treatment.