What is the appropriate dosage of Augmentin (amoxicillin-clavulanate) for an 11-year-old female patient weighing 49 kilograms with normal renal function, who can take oral tablets, for the treatment of streptococcal pharyngitis?

From the Guidelines

For an 11-year-old female weighing 49 kg with strep throat who can take pills, the recommended Augmentin (amoxicillin-clavulanate) dosage is not explicitly stated in the provided guidelines, but based on the available information, amoxicillin is recommended at a dose of 50 mg/kg once daily (maximum = 1000 mg) or 25 mg/kg twice daily (maximum = 500 mg) for 10 days 1.

To determine the appropriate dosage of Augmentin for this patient, we need to consider the recommended dosage of amoxicillin. Since the patient weighs 49 kg, the calculated dose would be:

• 50 mg/kg once daily: 50 mg/kg x 49 kg = 2450 mg, which exceeds the maximum recommended dose of 1000 mg. Therefore, the maximum dose of 1000 mg once daily can be considered.
• Alternatively, 25 mg/kg twice daily: 25 mg/kg x 49 kg = 1225 mg, which also exceeds the maximum recommended dose of 500 mg per dose for twice daily administration. Thus, the maximum dose of 500 mg twice daily can be considered.

Given these calculations and considering the standard dosing of Augmentin, which typically comes in formulations like 875 mg/125 mg (amoxicillin/clavulanate), the most appropriate dosage for an 11-year-old female weighing 49 kg would be 875 mg/125 mg twice daily for 10 days, as this aligns closely with the maximum recommended dose for amoxicillin in this context and is a common formulation used for treating streptococcal pharyngitis in patients who can take oral tablets.

The medication should be taken with food to minimize stomach upset. Completing the entire 10-day course is crucial, even if symptoms improve before then, to prevent recurrence or complications. Common side effects include diarrhea, nausea, and rash. Probiotics may help reduce antibiotic-associated diarrhea. If severe diarrhea, significant rash, or difficulty breathing occurs, seeking medical attention immediately is advised. Augmentin works by combining amoxicillin, which kills susceptible bacteria by interfering with cell wall synthesis, with clavulanate, which protects amoxicillin from being broken down by bacterial enzymes, making it effective against Group A Streptococcus and helping to prevent complications like rheumatic fever.

From the Research

Dosage of Augmentin for Streptococcal Pharyngitis

The appropriate dosage of Augmentin (amoxicillin-clavulanate) for an 11-year-old female patient weighing 49 kilograms with normal renal function is not explicitly stated in the provided studies. However, we can look at the general guidelines and recommendations for the treatment of streptococcal pharyngitis.

Treatment Guidelines

• The American Academy of Pediatrics recommends a 10-day course of penicillin V or amoxicillin for the treatment of streptococcal pharyngitis 2.
• Alternative antibiotics, such as cephalosporins or macrolides, may be used in patients who are allergic to penicillin or have a history of treatment failure 2.
• The dosage of amoxicillin-clavulanate for children is typically based on the child's weight, with a recommended dose of 45-60 mg/kg/day divided into 2-3 doses 3.

Specific Dosage Recommendations

• A study published in 2004 compared the efficacy of clarithromycin, amoxicillin-clavulanate, and penicillin V for the treatment of streptococcal tonsillopharyngitis in children. The study used a dose of 43.8/6.2 mg/kg/day of amoxicillin-clavulanate, divided into 2 doses, for 5 days 3.
• Another study published in 2024 compared the efficacy of amoxicillin-clavulanate in dispersible tablets versus film-coated tablets for the treatment of acute streptococcal tonsillopharyngitis. The study used a dose of 875+125 mg, 2 times a day, for 10 days 4.

Key Points to Consider

• The dosage of Augmentin (amoxicillin-clavulanate) for an 11-year-old female patient weighing 49 kilograms with normal renal function may be estimated based on the child's weight, with a recommended dose of 45-60 mg/kg/day divided into 2-3 doses.
• The treatment duration for streptococcal pharyngitis is typically 10 days, although some studies have investigated shorter treatment courses with alternative antibiotics.
• The choice of antibiotic and dosage should be based on the patient's medical history, allergy status, and local resistance patterns, as well as the severity of the infection and the patient's response to treatment.

Some key points to consider when determining the dosage of Augmentin for this patient include:

• The patient's weight and age
• The severity of the infection
• The patient's medical history and allergy status
• Local resistance patterns and treatment guidelines
• The potential for adverse effects and interactions with other medications

It is essential to consult with a healthcare professional to determine the most appropriate treatment plan for this patient.