What is the recommended dose of amoxicillin for a patient weighing 173.2 lbs, given a dose range of 80-90 mg/kg/day?

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Amoxicillin Dosing for a 173.2 lb Patient

For a patient weighing 173.2 lbs (78.6 kg), the recommended amoxicillin dose at 80-90 mg/kg/day would be 6,288-7,074 mg per day, which should be divided into 2-3 doses.

Calculation and Dosing Recommendation

  1. Convert weight from pounds to kilograms:

    • 173.2 lbs = 78.6 kg
  2. Calculate total daily dose:

    • At 80 mg/kg/day: 80 mg/kg × 78.6 kg = 6,288 mg/day
    • At 90 mg/kg/day: 90 mg/kg × 78.6 kg = 7,074 mg/day
  3. Dosing schedule:

    • Divided into 2-3 doses per day (every 8-12 hours)
    • For twice daily dosing: 3,144-3,537 mg every 12 hours
    • For three times daily dosing: 2,096-2,358 mg every 8 hours

Clinical Considerations

  • This high-dose amoxicillin regimen (80-90 mg/kg/day) is typically used for:

    • Severe infections
    • Infections in areas with high prevalence of drug-resistant organisms
    • Specific conditions like pneumonia in children 1
  • Standard adult dosing for amoxicillin is typically lower (750-1750 mg/day) 2, but higher doses are warranted in specific clinical scenarios requiring increased coverage.

  • The FDA label for amoxicillin indicates that adult dosing ranges from 750 to 1750 mg/day in divided doses every 8 to 12 hours 2, but clinical guidelines support higher dosing in specific situations.

Important Considerations

  • Renal function should be assessed before administering this dose, as dose reduction is necessary for patients with severe renal impairment (GFR >30 mL/min) 2.

  • The calculated dose exceeds typical adult maximum doses, so consider rounding to a practical dosing regimen using available formulations (250 mg, 500 mg tablets or 125 mg/5 mL, 250 mg/5 mL suspensions).

  • For practical administration, consider:

    • 3,000 mg twice daily (6,000 mg/day)
    • 2,000 mg three times daily (6,000 mg/day)

Common Pitfalls to Avoid

  1. Weight conversion errors: Always convert pounds to kilograms accurately (1 kg = 2.2 lbs).

  2. Dosing frequency errors: High-dose amoxicillin should be divided into multiple daily doses to maintain therapeutic levels.

  3. Failure to adjust for renal function: Patients with impaired renal function require dose adjustments.

  4. Using patient-estimated weight: When possible, patients should be weighed rather than relying on self-reported weights, as studies show healthcare provider estimates can be off by more than 10% in about half of cases 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Who should be estimating a patient's weight in the emergency department?

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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