What is the recommended dosage of Amoxiclav (amoxicillin/clavulanic acid) for a child weighing 14kg?

Amoxiclav Dosing for a 14kg Child

For a child weighing 14kg, the recommended dosage of amoxicillin/clavulanic acid (Amoxiclav) is 45 mg/kg/day in 2 divided doses for standard dosing, or 80-90 mg/kg/day of the amoxicillin component with 6.4 mg/kg/day of clavulanate in 2 divided doses for high-dose therapy. 1

Standard vs. High-Dose Therapy

Standard Dosing (45 mg/kg/day):

• For a 14kg child: 630mg total daily dose (315mg twice daily)
• Appropriate for mild to moderate infections in children who:
  • Are older than 2 years
  • Do not attend childcare
  • Have not received antibiotics in the past 4 weeks 1

High-Dose Therapy (80-90 mg/kg/day of amoxicillin component):

• For a 14kg child: 1120-1260mg total daily dose (560-630mg twice daily)
• Recommended for:
  • Children under 2 years
  • Those attending childcare
  • Recent antibiotic use (within 4 weeks)
  • Moderate to severe infections
  • Areas with high prevalence of resistant S. pneumoniae (>10%) 1

Clinical Decision-Making Algorithm

1. Assess infection severity and risk factors:

   • Age (under 2 years increases risk)
   • Childcare attendance
   • Recent antibiotic use
   • Local resistance patterns

2. Select appropriate dosing:

   • Low risk: Standard dose (45 mg/kg/day)
   • High risk: High dose (80-90 mg/kg/day)

3. Determine administration schedule:

   • Divide total daily dose into 2 equal doses given 12 hours apart

Important Considerations

• Duration of therapy: Typically 7-10 days, but may be individualized based on clinical response (continue for 7 days after the patient becomes symptom-free) 1
• Formulation selection: Choose appropriate strength suspension based on child's weight and required dose
• Monitoring: Assess clinical response within 48-72 hours; consider alternative therapy if no improvement 2

Common Pitfalls to Avoid

1. Underdosing: Using age-based rather than weight-based dosing can lead to inadequate treatment, especially in children who are larger or smaller than average for their age 3

2. Inappropriate formulation selection: Using adult formulations or incorrect suspension strengths can lead to dosing errors

3. Failure to adjust for risk factors: Not considering risk factors for resistant organisms can lead to treatment failure

4. Inadequate duration: Stopping therapy too soon can lead to recurrence of infection

5. Gastrointestinal side effects: Administering with food can help reduce GI upset, which is the most common adverse effect

By following these guidelines and considering the child's specific risk factors, you can optimize the effectiveness of amoxicillin/clavulanic acid therapy while minimizing the risk of treatment failure and antimicrobial resistance.