From the FDA Drug Label
Table 1 ... Ear/Nose/Throat Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours Severe 875 mg every 12 hours or 500 mg every 8 hours 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours
For a 6-year-old, 19.5kg pediatric patient with Acute Otitis Media (AOM), the recommended dosage of amoxicillin is:
- Mild/Moderate: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours
- Severe: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours
Using the Mild/Moderate dosage, the total daily dose would be:
- 25 mg/kg/day x 19.5 kg = 487.5 mg/day, which can be divided into 2-3 doses
- 20 mg/kg/day x 19.5 kg = 390 mg/day, which can be divided into 3 doses
Using the Severe dosage, the total daily dose would be:
- 45 mg/kg/day x 19.5 kg = 877.5 mg/day, which can be divided into 2 doses
- 40 mg/kg/day x 19.5 kg = 780 mg/day, which can be divided into 2-3 doses
The prescription for Amoxicillin in this patient would be approximately 390-490 mg per day for mild/moderate AOM, or 780-880 mg per day for severe AOM, divided into 2-3 doses, for a minimum of 10 days 1.
From the Research
Prescription for Amoxicillin in a 6-year-old Pediatric Patient with Acute Otitis Media (AOM)
The prescription for amoxicillin in a 6-year-old, 19.5kg pediatric patient with AOM is typically based on the patient's weight and the severity of the infection.
- The recommended dosage of amoxicillin for uncomplicated AOM in children is high-dose amoxicillin (80-90 mg/kg/day) 2.
- For a 19.5kg child, the calculated dosage would be:
- 80 mg/kg/day: 19.5kg x 80 mg/kg = 1560 mg/day
- 90 mg/kg/day: 19.5kg x 90 mg/kg = 1755 mg/day
- The dosage can be divided into two or three doses per day, depending on the formulation and the child's tolerance 3, 4.
- It is essential to note that the emergence of drug-resistant bacteria has led to a recommendation to use high-dose amoxicillin rather than standard-dose amoxicillin to treat children with AOM 3.
- Amoxicillin/clavulanic acid is also an effective treatment option for AOM in pediatric patients, especially in cases where involvement of resistant pathogens is suspected 4.
Considerations for Treatment
- The choice of antibiotic and dosage should be based on the severity of the infection, the patient's weight, and the potential for antibiotic resistance 5, 2.
- The treatment should be guided by recent recommendations and the available data, taking into account the potential benefits and risks of different antibiotic regimens 4, 6.
- Patient convenience, compliance, and dosing accuracy should also be considered when selecting a treatment option 6.