What is the appropriate dose of amoxicillin for a 9-year-old child weighing 25.6 kilograms with streptococcal pharyngitis?

From the Guidelines

For a 9-year-old child weighing 25.6 kg with streptococcal pharyngitis, I recommend giving 50 mg/kg once daily (maximum = 1000 mg) of amoxicillin, which translates to approximately 1280 mg per day, but since the maximum dose is 1000 mg, the dose should be 1000 mg once daily. The dosing is based on the standard recommendation from the most recent and highest quality study 1, which suggests 50 mg/kg once daily (maximum = 1000 mg) of amoxicillin for 10 days to ensure complete eradication of the bacteria. Some key points to consider when administering amoxicillin to a child with streptococcal pharyngitis include:

• Completing the full course of antibiotics, even if symptoms improve within a few days, to prevent recurrence or complications
• Using a measuring device specific for medication to ensure accurate dosing
• Refrigerating the suspension and shaking it well before each dose
• Being aware of potential side effects, such as diarrhea, stomach upset, or rash It's also important to note that the diagnosis of streptococcal pharyngitis should be established through accurate diagnosis, such as throat culture or rapid antigen detection test, to prevent inappropriate administration of antimicrobials to patients with non-streptococcal pharyngitis 1. The treatment of streptococcal pharyngitis is crucial to prevent complications, such as acute rheumatic fever, and to reduce the transmission of Group A Streptococcus to close contacts 1.

From the FDA Drug Label

Table 1 ... 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 ...

The appropriate dose of amoxicillin for a 9-year-old child weighing 25.6 kilograms with streptococcal pharyngitis is:

• 25 mg/kg/day in divided doses every 12 hours
• or 20 mg/kg/day in divided doses every 8 hours For this patient, the dose would be:
• 25 mg/kg/day: 25.6 kg x 25 mg/kg = 640 mg/day, divided into 2-3 doses
• 20 mg/kg/day: 25.6 kg x 20 mg/kg = 512 mg/day, divided into 3 doses 2

From the Research

Amoxicillin Dosage for Streptococcal Pharyngitis

• The appropriate dose of amoxicillin for a 9-year-old child weighing 25.6 kilograms with streptococcal pharyngitis is not directly stated in the provided studies.
• However, according to the study 3, first-line treatment for GABHS pharyngitis includes a 10-day course of penicillin or amoxicillin.
• The study 4 provides a rule for calculating drug dosages for children based on weight, which can be used to estimate the dose of amoxicillin.
• For a child weighing 25.6 kg, the dose of amoxicillin can be estimated using the rule: up to 30 kg, a child's drug dose may be (wt x 2)% of an adult dose.
• Assuming the adult dose of amoxicillin is 500 mg, the estimated dose for a 25.6 kg child would be (25.6 x 2)% of 500 mg, which is approximately 256 mg.
• However, the study 5 mentions that amoxicillin/clavulanate was administered at a dose of 43.8/6.2 mg/kg/day twice daily for 5 days, which can be used as a reference for the dosage of amoxicillin.

Considerations for Treatment

• The choice of antibiotic and dosage should be based on the severity of the infection, the patient's weight, and any allergies or sensitivities to medications 3.
• The treatment duration for streptococcal pharyngitis is typically 10 days, as stated in the study 3.
• It is essential to note that the studies provided do not directly address the specific dosage of amoxicillin for a 9-year-old child weighing 25.6 kg, and the estimated dose should be used as a reference only. Consultation with a healthcare professional is necessary to determine the appropriate treatment regimen.