From the Guidelines
For a 6-month-old male infant with acute otitis media, the recommended dosage of amoxicillin is 80-90 mg/kg/day, which translates to approximately 472-531 mg per day for this child, given the child's weight of 5.9 kilograms. This dosage is based on the guideline released by the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) in 2004, as reported in the American Family Physician journal 1.
Calculating the Dosage
To calculate the dosage, we can use the recommended range of 80-90 mg/kg/day. Given the child's weight of 5.9 kg, the total daily dosage would be:
- 80 mg/kg/day * 5.9 kg = 472 mg per day
- 90 mg/kg/day * 5.9 kg = 531 mg per day
Administration
This total daily dosage can be divided into two or three doses, depending on the formulation and concentration of the amoxicillin suspension. For example, if using a 400 mg/5mL suspension, the dosage would be approximately 5.9-6.6 mL twice daily, assuming a twice-daily regimen.
Importance of Completion
It's crucial to complete the full course of antibiotics as prescribed, even if symptoms improve before the medication is finished, to ensure the infection is fully cleared and reduce the risk of antibiotic resistance.
Choice of Antibiotic
Amoxicillin is recommended as the first-line treatment for acute otitis media due to its effectiveness against the common bacterial causes, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, as well as its safety profile, cost-effectiveness, and acceptable taste for pediatric patients 1.
From the Research
Amoxicillin Dosage for Acute Otitis Media
- The appropriate dosage of Amoxicillin for a 6-month-old male infant with acute otitis media, weighing 5.9 kilograms (13 pounds), can be determined based on the available evidence.
- According to the study 2, high-dose amoxicillin (80 to 90 mg/kg/d divided twice daily) is recommended for the treatment of acute otitis media.
- Another study 3 suggests that a dosing regimen of 75 to 90 mg/kg/day is recommended for acute otitis media, as the current amoxicillin dosing recommendation of 40 mg/kg/day in three divided doses is inadequate to effectively eradicate resistant Streptococcus pneumoniae.
- A study 4 evaluated the bacteriologic and clinical efficacy of high-dose amoxicillin (80 mg/kg/day three times a day for 10 days) as first-line therapy in acute otitis media, and found that eradication was achieved in 41 (82%) patients for 54 of 65 (83%) pathogens.
Calculation of Amoxicillin Dosage
- Based on the recommended dosage of 80 to 90 mg/kg/d, the calculated dosage for a 5.9 kg infant would be:
- 80 mg/kg/d: 5.9 kg x 80 mg/kg = 472 mg/d, divided into two doses: 236 mg/dose
- 90 mg/kg/d: 5.9 kg x 90 mg/kg = 531 mg/d, divided into two doses: 265.5 mg/dose
Comparison with Other Studies
- Other studies 5, 6 compared the safety and efficacy of clarithromycin and amoxicillin/clavulanate in the treatment of acute otitis media, but did not provide specific dosage recommendations for amoxicillin.
- However, these studies suggest that amoxicillin is an effective treatment for acute otitis media, and that high-dose amoxicillin may be necessary to effectively eradicate resistant pathogens 2, 3, 4.