What are the typical pediatric doses per kilogram for common medications?

From the Guidelines

Pediatric medication dosing is typically calculated based on a child's weight in kilograms to ensure safety and efficacy. For common antibiotics, the dosing varies by medication and age group. Some key dosages include:

• Amikacin: 15-22.5 mg/kg/day divided every 8 hours 1
• Ampicillin: 100-200 mg/kg/day divided every 6 hours 1
• Azithromycin: 10 mg/kg on day one followed by 5 mg/kg daily for 4 days 1
• Cefotaxime: 150 mg/kg every 8 hours 1
• Ceftriaxone: 50-75 mg/kg/day divided every 12-24 hours 1
• Gentamicin: 3-6 mg/kg/day divided every 8 hours 1

When administering these medications, it's crucial to:

• Verify the child's current weight
• Check for allergies
• Ensure the correct concentration of medication is being used, especially for liquid formulations These weight-based calculations are necessary because children have different metabolic rates, body compositions, and organ maturity compared to adults, affecting how drugs are processed in their bodies. Always double-check calculations and consult appropriate pediatric dosing references when administering medications to children.

Some medications have specific dosing recommendations based on age and weight, such as:

• Oseltamivir: 30 mg twice a day for children weighing 15 kg or less, 45 mg twice a day for children weighing more than 15-23 kg, 60 mg twice a day for children weighing more than 23-40 kg, and 75 mg twice a day for children weighing more than 40 kg 1
• Rifampin: 10-20 mg/kg/day divided every 12-24 hours 1

It's essential to consult the most recent and reliable pediatric dosing guidelines, such as those from the American Academy of Pediatrics or the Centers for Disease Control and Prevention, to ensure accurate and safe medication administration in children.

From the FDA Drug Label

Table 1

Recommended Dosage for Pediatric Patients Aged 3 Months and Older and Weight Less than 40 kg

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

Skin/Skin Structure

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

Genitourinary Tract

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

Lower Respiratory Tract

Mild/ Moderate or Severe

45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours

The typical pediatric doses per kilogram for amoxicillin are:

• Mild/Moderate infections: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours
• Severe infections: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours 2

From the Research

Pediatric Medication Doses per Kilogram

The following are typical pediatric doses per kilogram for common medications:

• Amoxicillin: 60 mg/kg/day in two divided doses for common uncomplicated infections 3
• Paracetamol: 60 mg/kg/day in four divided doses for pain management 3
• Acetaminophen:
  • IV administration: 15 mg/kg every 6 hours 4
  • Oral administration: bioavailability is approximately 72%, so dose adjustment may be necessary to achieve therapeutic levels 4

General Dosing Considerations

When calculating pediatric doses, it is essential to consider the child's weight, age, and level of organ maturity 5

• For children up to 30 kg, a common rule of thumb is to use (wt x 2)% of an adult dose 6
• For children over 30 kg, a common rule of thumb is to use (wt + 30)% of an adult dose 6
• Patient weight should be included on all medication prescriptions to ensure accurate dosing 7