What is the recommended dosing for amoxicillin (amoxicillin) in an adult with an ear infection?

From the Guidelines

For adults with an ear infection, the recommended dosing for amoxicillin is 1.5-4 g/day, with a typical dose of 500 mg taken orally three times daily (every 8 hours) or 875 mg twice daily (every 12 hours) for 5-10 days. The dosage may vary depending on the severity of the disease and the presence of risk factors for infection with resistant pathogens, such as recent antibiotic use 1.

Key Considerations

• The total daily dose of amoxicillin can range from 1.5 to 4 g/day, with lower doses (1.5 g/day) suitable for mild disease and higher doses (4 g/day) for moderate disease or areas with high prevalence of penicillin-resistant S pneumoniae 1.
• The medication should be taken with or without food, though taking it with food may help reduce stomach upset.
• It's essential to complete the full course of antibiotics even if symptoms improve before finishing the prescription.
• Amoxicillin works by inhibiting bacterial cell wall synthesis, which is effective against many common ear infection pathogens.
• If symptoms don't improve within 48-72 hours, or if they worsen, contact your healthcare provider as a different antibiotic may be needed.

Special Considerations

• Some patients may require a higher dose of 875 mg three times daily for severe infections or if resistant bacteria are suspected.
• Common side effects include diarrhea, nausea, and rash.
• Those with penicillin allergy should not take amoxicillin and should inform their healthcare provider immediately.

Dosage Summary

• Typical dose: 500 mg orally three times daily (every 8 hours) or 875 mg twice daily (every 12 hours) for 5-10 days.
• Range: 1.5-4 g/day, depending on disease severity and risk factors.

From the FDA Drug Label

In Adults, 750 to 1750 mg/day in divided doses every 8 to 12 hours Upper Respiratory Tract Infections of the Ear, Nose, and Throat

The recommended dosing for amoxicillin in an adult with an ear infection is 750 to 1750 mg/day in divided doses every 8 to 12 hours 2.

• The dose is based on the severity of the infection and the patient's renal function.
• It is essential to follow the prescribed dosage and administration instructions to ensure effective treatment and minimize the risk of adverse reactions.

From the Research

Amoxicillin Dosing for Ear Infections in Adults

• The provided studies do not directly address the recommended dosing for amoxicillin in adults with ear infections.
• However, studies 3, 4, 5 discuss the efficacy of amoxicillin in treating acute otitis media (AOM) in children, with dosing regimens ranging from 40 mg/kg/day to 90 mg/kg/day.
• Study 6 compares the efficacy of amoxicillin-clavulanate given every 12 hours versus every 8 hours in treating acute bacterial maxillary sinusitis in adults, with dosing regimens of 875 mg amoxicillin every 12 hours or 500 mg every 8 hours.
• Study 7 investigates the use of amoxicillin-clavulanic acid in preventing otitis media in children with presumed viral upper respiratory infection, with a dosing regimen of 75 mg/kg/day (25 mg/kg every 8 hours).

Considerations for Adult Dosing

• While the studies do not provide direct guidance on amoxicillin dosing for ear infections in adults, they suggest that higher doses may be more effective in treating bacterial infections, including those caused by resistant strains 3, 5.
• The dosing regimen for adults with ear infections may need to be adjusted based on factors such as the severity of the infection, the presence of resistant bacteria, and the patient's renal function.
• Further research is needed to determine the optimal dosing regimen for amoxicillin in adults with ear infections.