Azithromycin Dosing for a 2-Year-Old with Mycoplasma Infection
For a 2-year-old child weighing 33.8 pounds (15.3 kg) with a Mycoplasma infection, the recommended dose of azithromycin 200mg/5mL suspension is 10 mg/kg (153 mg) on day 1, followed by 5 mg/kg (76.5 mg) daily for days 2-5.
Dosage Calculation
Based on the FDA-approved dosing guidelines for azithromycin in pediatric patients with community-acquired pneumonia:
- Weight: 33.8 pounds = 15.3 kg
- Day 1 dose: 10 mg/kg = 153 mg (approximately 3.8 mL of 200mg/5mL suspension)
- Days 2-5 dose: 5 mg/kg = 76.5 mg (approximately 1.9 mL of 200mg/5mL suspension)
Administration Guidelines
- Azithromycin suspension can be given with or without food 1
- Food may improve gastrointestinal tolerability 2
- The full 5-day course should be completed even if symptoms improve before completion
Evidence-Based Rationale
The American Academy of Pediatrics and the Infectious Diseases Society of America recommend azithromycin for treatment of atypical pneumonia caused by Mycoplasma, particularly in children 2. For community-acquired pneumonia in children, the recommended dosage is 10 mg/kg on day 1 followed by 5 mg/kg on days 2-5 1.
This dosing regimen is supported by the FDA drug label which specifically states for pediatric patients with community-acquired pneumonia: "10 mg/kg as a single dose on the first day followed by 5 mg/kg on Days 2 through 5" 1.
Monitoring and Follow-up
- Clinical improvement should be assessed within 48-72 hours of starting therapy 3
- If no improvement or worsening occurs within this timeframe, reevaluation is necessary 3
- Common side effects to monitor include gastrointestinal symptoms (diarrhea, nausea, abdominal pain)
Important Considerations
- The full 5-day course should be completed to ensure eradication of the infection and prevent development of resistance
- If the child vomits shortly after administration, consult a healthcare provider about re-dosing
- Azithromycin has better activity against Mycoplasma pneumoniae compared to other antibiotics like doxycycline in young children
Practical Administration Tips
- Use a calibrated medication syringe or dosing spoon for accurate measurement
- Shake the suspension well before each use
- Store the suspension as directed on the package (typically at room temperature)
- Discard any unused medication after the treatment course is completed
Remember that clinical improvement should be evident within 48-72 hours of starting appropriate therapy. If the child's condition deteriorates or shows no improvement within this timeframe, further investigation should be performed.