Appropriate Dosing of Augmentin (Amoxicillin-Clavulanate) for a 20-Pound Child
For a 20-pound (approximately 9 kg) child, the appropriate dose of Augmentin liquid is 45 mg/kg/day divided into two doses for severe infections, or 25 mg/kg/day divided into two doses for mild to moderate infections.
Dosage Calculation
The FDA-approved dosing for amoxicillin-clavulanate is based on the child's weight and severity of infection:
Mild to Moderate Infections:
- 25 mg/kg/day divided into doses every 12 hours
- For a 9 kg child: 225 mg/day (112.5 mg twice daily)
Severe Infections:
- 45 mg/kg/day divided into doses every 12 hours
- For a 9 kg child: 405 mg/day (202.5 mg twice daily)
Administration Guidelines
- Augmentin should be administered at the start of a meal to minimize gastrointestinal intolerance 1
- The suspension should be shaken well before each use
- Treatment should generally continue for a minimum of 48-72 hours after the child becomes asymptomatic 1
- For streptococcal infections, a minimum of 10 days of treatment is recommended to prevent acute rheumatic fever 1
Special Considerations
Age Considerations
- For children less than 12 weeks (3 months) old, the recommended upper dose is 30 mg/kg/day divided every 12 hours due to incompletely developed renal function 1
- For children 3 months and older, standard dosing applies based on weight and infection severity 1
Formulation Options
- Augmentin is available in different concentrations:
Clinical Efficacy and Use
Augmentin is effective against common pediatric pathogens including:
- Penicillin-susceptible and intermediate strains of Streptococcus pneumoniae
- Beta-lactamase producing strains of Haemophilus influenzae
- Moraxella catarrhalis 4
For recurrent or persistent infections, particularly acute otitis media, the high-dose formulation (90 mg/kg/day of amoxicillin component) may be considered if resistant pathogens are suspected 4, 3.
Potential Side Effects
The most common adverse effects in children are:
- Mild gastrointestinal disturbances
- Diarrhea (less frequent with twice-daily dosing compared to three-times-daily) 4
Important Precautions
- Ensure the correct concentration is selected when calculating the dose
- After reconstitution, the suspension must be discarded after 14 days
- Refrigeration is preferable but not required 1
- For children with severe renal impairment (GFR <30 mL/min), dose adjustment is necessary 1
Always verify the child's exact weight before calculating the dose, and consider the severity of infection when determining the appropriate dosage regimen.