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 amoxicillin at a dose of 50 mg/kg once daily, which translates to approximately 1280 mg per day, with a maximum dose of 1000 mg per day, as the most appropriate treatment option, based on the strongest and most recent evidence from 1.

Key Considerations

• The recommended dosage range for amoxicillin in the treatment of streptococcal pharyngitis is 50 mg/kg once daily, with a maximum of 1000 mg per day, as stated in 1.
• The calculation for the dose is based on the child's weight, which is 25.6 kg, resulting in a dose of approximately 1280 mg per day, but the maximum dose of 1000 mg per day should not be exceeded.
• It is crucial to complete the full 10-day course of treatment, even if symptoms improve earlier, to ensure complete eradication of the bacteria and prevent potential complications, as emphasized in 1.

Administration and Monitoring

• The medication can be given with or without food, but taking it with food may help reduce stomach upset.
• Use a medication syringe or dosing spoon for accurate measurement rather than household teaspoons to ensure the correct dose is administered.
• Amoxicillin works by inhibiting bacterial cell wall synthesis, effectively killing the Streptococcus bacteria causing the throat infection, as described in 1.

Evidence-Based Decision

• The recommendation is based on the strongest and most recent evidence from 1, which provides a strong, high-quality recommendation for the use of amoxicillin in the treatment of streptococcal pharyngitis.
• The evidence from 1 also supports the use of amoxicillin, but 1 is considered the most recent and highest quality study, making it the primary basis for the recommendation.

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, which is approximately 640 mg/day (25.6 kg x 25 mg/kg), or
• 20 mg/kg/day in divided doses every 8 hours, which is approximately 512 mg/day (25.6 kg x 20 mg/kg) 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 3, 4, 5, 6, 7.
• However, study 6 mentions that short-course therapy with 6 days of amoxicillin is a reasonable alternative to traditional 10-day penicillin therapy for group A beta-haemolytic streptococcal tonsillopharyngitis.
• The dosage of amoxicillin is not specified in study 6, but it can be inferred that the standard dosage for children is typically based on their weight, with a common dosage range of 25-50 mg/kg/day divided into 2-3 doses 6.
• Study 7 discusses the failure rate of penicillin therapy, but does not provide specific dosage information for amoxicillin.

Considerations for Amoxicillin Therapy

• The choice of antibiotic and duration of therapy should be based on the severity of symptoms, patient compliance, and local resistance patterns 5, 6, 7.
• Short-course therapy may be effective for some patients, but more research is needed to determine the optimal duration and dosage of amoxicillin for streptococcal pharyngitis in children 6.