Azithromycin Dosing for a 2-Year-Old Child
The recommended dose of azithromycin (Zithromax) for a 2-year-old child depends on the condition being treated, with the standard dosing being 10 mg/kg on day 1, followed by 5 mg/kg on days 2-5 for most infections. 1
Dosing Guidelines by Condition
Standard 5-Day Regimen
- Day 1: 10 mg/kg as a single dose
- Days 2-5: 5 mg/kg once daily
- This regimen is appropriate for community-acquired pneumonia and most respiratory infections 1
3-Day Regimen
- Days 1-3: 10 mg/kg once daily
- This regimen is appropriate for acute bacterial sinusitis and can be used for acute otitis media 1
1-Day Regimen (Otitis Media Only)
- Single dose: 30 mg/kg
- This regimen is only approved for acute otitis media 1
Pharyngitis/Tonsillitis
- Days 1-5: 12 mg/kg once daily
- Higher dose needed for adequate streptococcal coverage 1
Weight-Based Dosing Chart for a 2-Year-Old
For a typical 2-year-old weighing approximately 12 kg (26 lbs):
| Condition | Regimen | Day 1 Dose | Days 2-5 Dose | Total mg per Course |
|---|---|---|---|---|
| Pneumonia | 5-day | 120 mg | 60 mg | 360 mg |
| Otitis Media/Sinusitis | 3-day | 120 mg | 120 mg | 360 mg |
| Otitis Media | 1-day | 360 mg | - | 360 mg |
| Pharyngitis | 5-day | 144 mg | 144 mg | 720 mg |
Administration Guidelines
- Azithromycin oral suspension can be taken with or without food 1
- For the 100 mg/5 mL suspension, a 2-year-old would typically need:
- 6 mL (just over 1 teaspoon) for the 10 mg/kg dose
- 3 mL (about half a teaspoon) for the 5 mg/kg dose
Safety Considerations
- Azithromycin is generally well-tolerated in children with adverse events occurring in approximately 9% of patients 2
- Most common side effects are gastrointestinal (mild to moderate) 2
- Avoid concurrent administration with aluminum- or magnesium-containing antacids as they reduce absorption 3
- Monitor for potential drug interactions with medications metabolized by cytochrome P450 enzymes 3
Important Clinical Considerations
- The 3-day and 5-day regimens have shown comparable efficacy and tolerability in children with respiratory infections 4
- For severe infections, the 5-day regimen is preferred to ensure adequate treatment 3
- The safety of re-dosing after vomiting within 30 minutes of administration has not been established 1
- Once-daily administration results in sustained systemic exposure due to the drug's long half-life 5
Remember that dosing should be calculated based on the child's actual weight for maximum efficacy and safety.