What is the appropriate oral liquid dosing of Augmentin (amoxicillin-clavulanate) for a 6-year-old girl weighing 41.1 kilograms with streptococcal pharyngitis?

From the Guidelines

For a 6-year-old girl weighing 41.1 kg with strep pharyngitis, the recommended dosage of Augmentin (amoxicillin-clavulanate) oral liquid is 50 mg/kg once daily (max = 1000 mg) or 25 mg/kg twice daily (max = 500 mg), given for 10 days, as per the guidelines 1. This translates to approximately 2055 mg once daily or 1027.5 mg twice daily of the standard formulation.

• Augmentin should be given with food to improve absorption and reduce gastrointestinal side effects.
• Complete the entire 10-day course even if symptoms improve before then to ensure complete eradication of Group A Streptococcus and prevent complications like rheumatic fever.
• Common side effects include diarrhea, nausea, and rash.
• Probiotics may help reduce antibiotic-associated diarrhea.
• The high dose is necessary because Group A Streptococcus requires sufficient antibiotic concentration to overcome potential resistance, and the clavulanic acid component helps overcome beta-lactamase producing organisms that might be present in mixed infections of the throat. The Infectious Diseases Society of America recommends amoxicillin as an effective treatment for GAS pharyngitis, with a strong, high-quality evidence recommendation 2, 3, 1.
• The choice of amoxicillin is based on its proven efficacy, safety, narrow spectrum, and low cost.
• The dosage of 50 mg/kg once daily or 25 mg/kg twice daily is supported by comparative clinical trials, which have shown that once-daily amoxicillin is effective for GAS pharyngitis 3.
• It is essential to note that the patient's weight and the maximum dose should be considered when calculating the dosage.
• In this case, the patient's weight is 41.1 kg, and the maximum dose is 1000 mg for the once-daily regimen or 500 mg for the twice-daily regimen.

From the FDA Drug Label

The 250 mg/125 mg amoxicillin and clavulanate potassium tablet and the 250 mg/62. 5 mg chewable tablet should NOT be substituted for each other, as they are not interchangeable and the 250 mg/125 mg tablet should not be used in children weighing less than 40 kg.

The FDA drug label does not answer the question.

From the Research

Oral Liquid Dosing of Augmentin for Streptococcal Pharyngitis

The provided studies do not directly address the appropriate oral liquid dosing of Augmentin (amoxicillin-clavulanate) for a 6-year-old girl weighing 41.1 kilograms with streptococcal pharyngitis. However, some general information about the treatment of streptococcal pharyngitis can be gathered from the studies:

• The recommended first-line therapy for streptococcal pharyngitis is a 10-day course of penicillin V, usually given 2 or 3 times per day 4.
• Alternatives to penicillin V include other penicillins, macrolides, and cephalosporins, such as amoxicillin-clavulanate 4, 5.
• The dosage of amoxicillin-clavulanate is not specified in the provided studies, but a study on adult patients used a dosage of 875+125 mg 2 times a day 6.
• It is essential to note that the dosage of amoxicillin-clavulanate for children is typically based on their weight, and the exact dosage for a 6-year-old girl weighing 41.1 kilograms is not provided in the studies.

Key Points to Consider

• The treatment of streptococcal pharyngitis typically involves a 10-day course of antibiotics 4, 7, 6.
• Amoxicillin-clavulanate is an alternative to penicillin V for the treatment of streptococcal pharyngitis 4, 5.
• The dosage of amoxicillin-clavulanate for children should be based on their weight, but the exact dosage for a 6-year-old girl weighing 41.1 kilograms is not provided in the studies. Some possible dosages for pediatric patients are:
  • 25-45 mg/kg/day of amoxicillin, given in 2-3 divided doses 8
  • 40-50 mg/kg/day of amoxicillin, given in 2-3 divided doses (not specified in the provided studies)

It is crucial to consult a healthcare professional to determine the appropriate dosage of Augmentin for a 6-year-old girl weighing 41.1 kilograms with streptococcal pharyngitis.