From the Guidelines
The recommended dose of amoxicillin for community-acquired pneumonia (CAP) is 90 mg/kg/day in 2 doses for children, with a maximum dose of 4 g/day, and 500 mg three times daily or 875 mg twice daily for 5-7 days in adults with mild to moderate infection. When considering the treatment of CAP, it is essential to take into account the severity of the infection, the patient's age, and any potential allergies or resistance to antibiotics 1. For children, the dosage is weight-based, and the American Academy of Pediatrics recommends 90 mg/kg/day in 2 doses, with a maximum dose of 4 g/day 1. In adults, the dosage is typically 500 mg three times daily or 875 mg twice daily for 5-7 days in mild to moderate infections, with higher doses of 1 gram three times daily used for more severe cases 1. Some key points to consider when treating CAP with amoxicillin include:
- The importance of completing the full course of antibiotics, even if symptoms improve before finishing treatment
- The potential for gastrointestinal side effects, which can be reduced by taking amoxicillin with food
- The need to stay hydrated throughout treatment
- The possibility of resistance or allergy to amoxicillin, which may require alternative antibiotics or combination therapy 1. It is crucial to note that the treatment duration should generally be 5-7 days for uncomplicated cases, though longer courses may be needed for severe infections or those with complications 1. Overall, amoxicillin is an effective antibiotic for treating CAP, particularly against Streptococcus pneumoniae, but it is essential to use it judiciously and consider the individual patient's needs and circumstances 1.
From the FDA Drug Label
Infections of the Lower Respiratory Tract:Amoxicillin for oral suspension is indicated in the treatment of infections due to susceptible (ONLY β-lactamase–negative) isolates of Streptococcusspp. (α-and β-hemolytic isolates only), S. pneumoniae, Staphylococcusspp., or H. influenzae. Lower Respiratory Tract Mild/ Moderate or Severe 875 mg every 12 hours or 500 mg every 8 hours 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours
The recommended dose of amoxicillin for community-acquired pneumonia (CAP) is:
- 875 mg every 12 hours or
- 500 mg every 8 hours for adults, and
- 45 mg/kg/day in divided doses every 12 hours or
- 40 mg/kg/day in divided doses every 8 hours for pediatric patients aged 3 months and older and weight less than 40 kg 2.
From the Research
Amoxicillin Dose for Community-Acquired Pneumonia (CAP)
The recommended dose of amoxicillin for community-acquired pneumonia (CAP) varies depending on the patient population and the severity of the disease.
- For pediatric patients, a dose of 35-50 mg/kg/day or 70-90 mg/kg/day of amoxicillin can be used, with a treatment duration of 3 to 7 days 3.
- For adults, a dose of 1,000 mg tid (three times a day) of amoxicillin can be used for 10 days 4.
- Another study suggests that a high-dose regimen for life-threatening pneumococcal pneumonia in a 70-kg adult consists of a 3 million unit (mu) loading dose followed by continuous infusion of 10 to 12 mu of freshly prepared drug every 12 h 5.
- A systematic review and meta-analysis found that a short course of amoxicillin (5 days) is just as effective as a longer course (10 days) for uncomplicated CAP in children under 10 years old 6.
Factors Influencing Amoxicillin Dose
Several factors can influence the dose of amoxicillin used to treat CAP, including:
- Patient age and weight
- Severity of the disease
- Presence of underlying medical conditions, such as renal failure
- Suspected or confirmed resistance of the causative organism to amoxicillin
- Geographic location and prevalence of antibiotic-resistant organisms
Amoxicillin Formulations
Different formulations of amoxicillin are available, including:
- Oral amoxicillin syrup
- Amoxicillin/clavulanate (Augmentin) tablets or suspension
- High-dose amoxicillin/clavulanate formulations, such as Augmentin XR or Augmentin ES-600 7