What is the appropriate dose of Augmentin (amoxicillin-clavulanate) for a 7-year-old child weighing 54 pounds with cellulitis?

From the Guidelines

For a 7-year-old child weighing 54 pounds (approximately 24.5 kg) with cellulitis, the recommended Augmentin (amoxicillin-clavulanate) dosage is 90 mg/kg/day divided into two doses, as per the most recent guidelines 1. This translates to approximately 1100 mg twice daily of the amoxicillin component. The most appropriate formulation would be Augmentin 400mg/57mg per 5mL suspension, giving 13.75 mL twice daily for 7-10 days. This dosage provides adequate coverage against common skin infection pathogens including Staphylococcus aureus and Streptococcus species. The medication should be given with food to minimize gastrointestinal side effects. Parents should complete the full course even if symptoms improve before completion. Common side effects include diarrhea, nausea, and rash. If the child develops severe diarrhea, significant rash, or doesn't show improvement within 48-72 hours, they should be reassessed by a healthcare provider. Adequate hydration should be maintained throughout treatment.

Some key points to consider:

• The dosage is based on the amoxicillin component of Augmentin, which is the primary active ingredient against bacterial infections.
• The recommended duration of treatment is 7-10 days, but this may vary depending on the severity of the infection and the child's response to treatment.
• It is essential to complete the full course of treatment, even if symptoms improve before completion, to ensure that the infection is fully cleared and to reduce the risk of antibiotic resistance.
• The child should be monitored for common side effects, such as diarrhea, nausea, and rash, and reassessed by a healthcare provider if severe symptoms develop or if there is no improvement within 48-72 hours.
• Adequate hydration is crucial throughout treatment to help prevent dehydration and promote recovery.

Note: The recommended dosage is based on the most recent guidelines from the Journal of Microbiology, Immunology and Infection 1, which provides the most up-to-date and evidence-based recommendations for the treatment of pneumonia and other infections in children.

From the FDA Drug Label

Table 1 ... Skin/Skin Structure 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

The appropriate dose of Augmentin (amoxicillin-clavulanate) for a 7-year-old child weighing 54 pounds with cellulitis is:

• For mild to moderate infections: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours
• For severe infections: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours To calculate the dose:
• 54 pounds is approximately 24.5 kg
• Mild to moderate: 24.5 kg * 25 mg/kg/day = 612.5 mg/day, or 24.5 kg * 20 mg/kg/day = 490 mg/day
• Severe: 24.5 kg * 45 mg/kg/day = 1102.5 mg/day, or 24.5 kg * 40 mg/kg/day = 980 mg/day Given the child's weight is over 40 kg, the dose should not exceed the recommended adult dose. The recommended dose is 875 mg every 12 hours or 500 mg every 8 hours for severe skin and skin structure infections 2.

From the Research

Appropriate Dose of Augmentin for a 7-year-old Child with Cellulitis

• The provided studies do not directly address the appropriate dose of Augmentin (amoxicillin-clavulanate) for a 7-year-old child weighing 54 pounds with cellulitis 3, 4, 5, 6, 7.
• However, the studies discuss the management of cellulitis in various settings, including the use of oral antibiotics such as cephalexin and levofloxacin 5, 6.
• One study compared the efficacy of 5-day and 10-day courses of levofloxacin for uncomplicated cellulitis, but did not provide information on the use of Augmentin in children 6.
• Another study discussed the use of oral ciprofloxacin and clindamycin for orbital cellulitis, but did not provide guidance on the use of Augmentin in children with cellulitis 4.
• A systematic review and meta-analysis is currently underway to compare the efficacy of oral versus intravenous antibiotic administration for cellulitis infections, but the results are not yet available 7.

Antibiotic Treatment for Cellulitis in Children

• A study on the management of cellulitis in a pediatric emergency department found that oral antibiotics such as cephalexin were commonly used to treat noncomplicated, nonfacial cellulitis in children 5.
• The study found that treatment with oral antibiotics was effective and required fewer visits and less time in the emergency department compared to intravenous treatment 5.
• However, the study did not provide information on the use of Augmentin specifically, and the dosage and administration of antibiotics may vary depending on the individual patient and the severity of the infection.