What is the appropriate dose of Augmentin (amoxicillin-clavulanate) for an 11-year-old patient weighing 153 pounds?

Dosing of Augmentin for an 11-Year-Old Weighing 153 Pounds

For an 11-year-old child weighing 153 pounds (69.5 kg), the appropriate dose of Augmentin is 45 mg/kg/day of the amoxicillin component given in two divided doses, which equals approximately 1566 mg of amoxicillin per day (783 mg twice daily). 1

Weight-Based Dosing Calculation

1. Convert weight to kilograms:

   • 153 pounds = 69.5 kg

2. Calculate daily dose based on FDA-approved dosing:

   • For otitis media, sinusitis, lower respiratory tract infections, and more severe infections: 45 mg/kg/day of amoxicillin component 1
   • Total daily dose: 69.5 kg × 45 mg/kg = 3127.5 mg of amoxicillin component

3. Divide into appropriate dosing schedule:

   • Every 12 hours (preferred regimen): 1563.75 mg twice daily

Formulation Selection

Since this child weighs more than 40 kg (69.5 kg), adult dosing recommendations can be followed 1:

• Recommended formulation: 875 mg/125 mg tablet twice daily
  • This provides 1750 mg of amoxicillin per day, which is appropriate for the child's weight
  • The 875 mg/125 mg formulation is preferred for more severe infections and respiratory tract infections

Special Considerations

• Infection severity: For more severe infections, consider using the higher end of the dosing range (875 mg/125 mg tablets twice daily) 1

• Administration timing: Augmentin should be taken at the start of a meal to minimize gastrointestinal intolerance and enhance absorption of clavulanate 1

• Duration of therapy:

  • For most infections: 7-10 days
  • For streptococcal infections: minimum of 10 days to prevent rheumatic fever 2
  • For otitis media: 10 days 1

Potential Pitfalls

1. Common error: Using weight in pounds instead of kilograms for calculation

   • Always convert to kilograms first (153 lbs = 69.5 kg)

2. Formulation confusion: Different Augmentin formulations have different amoxicillin-to-clavulanate ratios

   • The 250 mg/125 mg tablet is not interchangeable with the 250 mg/62.5 mg chewable tablet 1
   • Two 250 mg/125 mg tablets should not be substituted for one 500 mg/125 mg tablet 1

3. Renal function consideration:

   • For patients with normal renal function, no dose adjustment is needed
   • If GFR < 30 mL/min, avoid the 875 mg/125 mg dose 1

Alternative Dosing for Special Situations

• For less severe infections: 25 mg/kg/day of amoxicillin component in two divided doses 1
• For patients unable to swallow tablets: 400 mg/57 mg per 5 mL suspension can be used in place of the 875 mg/125 mg tablet 1

By following these guidelines, you can ensure appropriate dosing of Augmentin for this 11-year-old patient weighing 153 pounds, optimizing treatment efficacy while minimizing adverse effects.