What is the appropriate dosage of Augmentin (amoxicillin-clavulanate) for a 12-year-old pediatric patient weighing 71 kilograms?

From the Guidelines

For a 12-year-old pediatric patient weighing 71 kilograms, the appropriate dosage of Augmentin (amoxicillin-clavulanate) should be determined by a healthcare provider, considering the severity of the infection and the patient's individual factors, but based on the provided evidence, a dose of 250/125 mg (amoxicillin/clavulanate) three times a day may be considered for patients in this age group 1.

Important Considerations

• The dosing of Augmentin depends on the type and severity of the infection being treated, as well as the patient's kidney function and other individual factors.
• The typical pediatric dosing range for Augmentin is based on the amoxicillin component, but since this child weighs 71 kg, which approaches adult weight, adult dosing might be considered.
• According to the British Thoracic Society guidelines for the management of community-acquired pneumonia in childhood 1, for patients aged 7-12 years, a dose of 5 ml (250/62 suspension) three times a day is recommended.
• However, given the patient's weight and age, it's crucial to consult with a healthcare provider to determine the most appropriate dose, as the guidelines may not directly address a patient of this specific weight and age.

Potential Risks and Benefits

• Giving medication without proper medical guidance can lead to ineffective treatment or potential side effects.
• It's essential to follow the prescribed dosage and administration instructions carefully to ensure the effectiveness of the treatment and minimize the risk of adverse effects.
• A healthcare provider can assess the child's condition and determine the appropriate dose, taking into account the severity of the infection, the patient's medical history, and other relevant factors 1.

From the FDA Drug Label

1. 2 Dosage for Adults and Pediatric Patients Aged 3 Months (12 weeks) and Older Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained It is recommended that there be at least 10 days’ treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever. In some infections, therapy may be required for several weeks. Table 1 (12 weeks) n 40 kg Recommended Dosage for Pediatric Patients Aged 3 Months and Older and Weight Less than 40 kg Ear/Nose/Throat Skin/Skin Structure Genitourinary Tract Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours 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 appropriate dosage of Augmentin (amoxicillin-clavulanate) for a 12-year-old pediatric patient weighing 71 kilograms is not explicitly stated in the provided drug label, as the label only provides dosing recommendations for patients weighing less than 40 kg. However, based on the information provided for adults and pediatric patients aged 3 months and older, the dosage for a patient over 40 kg would likely be the adult dosage. For mild to moderate infections, the recommended adult dosage is 500 mg every 12 hours or 250 mg every 8 hours. For severe infections, the recommended adult dosage is 875 mg every 12 hours or 500 mg every 8 hours. It is essential to consult the prescribing information for Augmentin (amoxicillin-clavulanate) specifically, as the provided label is for amoxicillin, and the dosing recommendations may differ 2.

From the Research

Dosage of Augmentin for a 12-year-old Pediatric Patient

• The appropriate dosage of Augmentin (amoxicillin-clavulanate) for a 12-year-old pediatric patient weighing 71 kilograms can be determined based on the studies provided.
• According to the study 3, high-dose amoxicillin (80 to 90 mg per kg per day in two divided doses) is first-line therapy for acute otitis media, and amoxicillin-clavulanate is typically used when the patient has taken amoxicillin for AOM in the previous 30 days or has concomitant purulent conjunctivitis.
• The study 3 also states that amoxicillin-clavulanate has predicted efficacy against all penicillin-susceptible and -intermediate pneumococci, as well as against most penicillin-resistant strains, at amoxicillin doses of 45-90 mg/kg per day in children.
• Another study 4 mentions a dosage of 25/3.6mg/kg/day for amoxycillin/clavulanate in children aged two to 12 years with lower respiratory tract infection, but this dosage is lower than the recommended high-dose amoxicillin.
• Based on the information provided, a suitable dosage of Augmentin for a 12-year-old pediatric patient weighing 71 kilograms could be calculated as follows:
  • 80-90 mg/kg/day of amoxicillin, which would be approximately 5680-6390 mg per day, divided into two doses.
  • Using the 25/3.6mg/kg/day dosage from study 4 as a reference, the total daily dose would be approximately 1785-2540 mg per day, which is lower than the recommended high-dose amoxicillin.
• It is essential to consult with a healthcare professional to determine the most appropriate dosage of Augmentin for a specific patient, as the dosage may vary depending on the patient's condition, age, and other factors.