What is the recommended dose of Augmentin (amoxicillin-clavulanate) for a 9-year-old child weighing 28 kg?

Augmentin Dosage for a 9-Year-Old Child Weighing 28 kg

For a 9-year-old child weighing 28 kg, the recommended dose of Augmentin (amoxicillin-clavulanate) is 45 mg/kg/day divided into two doses, which equals approximately 625 mg twice daily. 1

Dosage Calculation

The appropriate dosage can be determined based on the child's weight and the severity of infection:

Standard Dosing Approach:

• For mild to moderate infections: 25-45 mg/kg/day divided into 2 doses
• For severe infections: 45-90 mg/kg/day divided into 2 doses

For this 28 kg child:

• At 45 mg/kg/day: 28 kg × 45 mg/kg/day = 1260 mg/day
• Divided into two doses: 630 mg twice daily (rounded to 625 mg for practical administration)

Formulation Options

Augmentin is available in several formulations:

• Oral suspension (125/31,250/62 suspension)
• Tablets (250/125 mg)
• Augmentin ES-600 (high-dose formulation for specific pediatric infections)

For a 9-year-old weighing 28 kg, the appropriate formulation would be:

• 5 ml of 250/62 suspension twice daily 1
• OR one 250/125 mg tablet twice daily if the child can swallow tablets

Duration of Treatment

Treatment should typically continue for:

• 7-10 days for most respiratory infections 1
• Up to 14 days depending on clinical response 1

Important Considerations

1. Monitoring: Assess clinical improvement within 48-72 hours. If the child shows no improvement or deteriorates, reevaluation is necessary 1

2. Potential Side Effects: Monitor for gastrointestinal symptoms, which are the most common adverse effects

3. Dosage Adjustment: No dose adjustment is needed for this child as they have normal renal function. Dose adjustments would only be necessary if GFR is less than 30 mL/min

4. Administration Timing: Administer with food to minimize gastrointestinal side effects and improve absorption

Special Situations

For specific infections:

• For persistent or recurrent acute otitis media with risk factors for resistant pathogens, consider the higher-dose formulation (Augmentin ES-600) 2
• For severe respiratory infections where drug-resistant S. pneumoniae is suspected, higher dosing may be warranted

Remember that clinical response should guide treatment decisions, and failure to improve within 48-72 hours should prompt reevaluation of the diagnosis and treatment plan.