Is 7.4 mL of Augmentin (amoxicillin-clavulanate) for 10 days an appropriate treatment for a 3-year-old with periorbital cellulitis?

From the Guidelines

The use of 7.4 mL of Augmentin for 10 days in a 3-year-old with periorbital cellulitis is not definitively appropriate without knowing the concentration of the Augmentin suspension and the child's weight. The appropriate dosage of amoxicillin-clavulanate for periorbital cellulitis in children is typically 45-90 mg/kg/day of the amoxicillin component, divided into two doses 1. To determine the correct dose, a healthcare provider must calculate it based on the child's weight and the specific formulation of Augmentin being used. Some key considerations for treating periorbital cellulitis include:

• The severity of the infection, with more severe cases potentially requiring hospitalization and intravenous antibiotics 1
• Monitoring for worsening symptoms such as fever, significant swelling, vision changes, or limitations in eye movement, which may necessitate immediate medical attention
• The potential for periorbital cellulitis to be a complication of acute bacterial sinusitis, which may require comprehensive coverage with high-dose amoxicillin-clavulanate 1 Given the potential severity of periorbital cellulitis and its possible complications, it is crucial for a healthcare provider to assess the child and determine the most appropriate treatment regimen, which may include oral antibiotic therapy with close follow-up or hospitalization for intravenous antibiotics, depending on the severity of the condition and the child's overall health status 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 INFECTIONDOSING REGIMEN Every 12 hours 200 mg/5 mL or 400 mg/5 mL oral suspension a Otitis media b, sinusitis, lower respiratory tract infections, and more severe infections 45 mg/kg/day every 12 hours

To determine the appropriate dose for a 3-year-old patient with periorbital cellulitis, we need to calculate the dose based on the patient's weight. However, the patient's weight is not provided. Assuming the patient weighs around 14-15 kg (average weight for a 3-year-old), the dose would be approximately 45 mg/kg/day every 12 hours for more severe infections, which includes periorbital cellulitis. For a 14-15 kg patient, the dose would be around 630-675 mg/day, which is equivalent to approximately 10.5-11.25 mL/day of the 200 mg/5 mL suspension, or around 5.25-5.6 mL/day of the 400 mg/5 mL suspension, given every 12 hours. The prescribed dose of 7.4 mL for 10 days does not provide enough information about the concentration of the suspension, so it is unclear if this dose is appropriate. Given the information provided, the dose of 7.4 mL of Augmentin for 10 days may not be sufficient for a 3-year-old patient with periorbital cellulitis, depending on the concentration of the suspension and the patient's weight 2.

From the Research

Treatment of Periorbital Cellulitis

• The treatment of periorbital cellulitis typically involves antibiotics, with the goal of preventing serious complications and promoting recovery 3, 4, 5, 6, 7.
• The choice of antibiotic and duration of treatment may vary depending on the severity of the infection, the patient's age and health status, and the suspected causative organism 4, 5, 6.

Antibiotic Treatment

• Amoxicillin-clavulanic acid is a commonly used antibiotic for the treatment of periorbital cellulitis, particularly in children 5, 6.
• The duration of treatment with amoxicillin-clavulanic acid is typically between 7 and 10 days 5, 6.
• Other antibiotics, such as ceftriaxone and cefuroxime, may also be used in certain cases 7.

Dosage and Administration

• The dosage of amoxicillin-clavulanic acid for a 3-year-old child with periorbital cellulitis is typically based on the child's weight and the severity of the infection.
• A dose of 7.4 mL of Augmentin (amoxicillin-clavulanate) for 10 days may be appropriate for a 3-year-old child with periorbital cellulitis, but this should be determined by a healthcare professional based on the individual child's needs 5, 6.

Monitoring and Follow-up

• Children with periorbital cellulitis should be closely monitored for signs of complications, such as worsening symptoms, abscess formation, or intracranial complications 3, 4, 6, 7.
• Follow-up appointments with a healthcare professional are important to ensure that the infection is resolving and to adjust treatment as needed 6, 7.