Augmentin Dosing for a 30kg Child
For a 30kg child, the recommended dose of Augmentin (amoxicillin-clavulanate) is 45mg/kg/day of the amoxicillin component divided into two doses for mild to moderate infections, or 80-90mg/kg/day divided into two doses for severe infections. 1
Dosage Calculation
Standard Dosing (Mild to Moderate Infections)
- 45mg/kg/day of amoxicillin component
- For a 30kg child: 30kg × 45mg/kg/day = 1350mg/day
- Divided into 2 doses = 675mg per dose, every 12 hours
High-Dose Regimen (Severe Infections)
- 80-90mg/kg/day of amoxicillin component
- For a 30kg child: 30kg × 90mg/kg/day = 2700mg/day
- Divided into 2 doses = 1350mg per dose, every 12 hours
Formulation Selection
Based on the child's weight (30kg), the appropriate formulation would be:
- For standard dosing: Augmentin 400mg/57mg per 5ml suspension (675mg dose = approximately 8.4ml per dose)
- For high-dose regimen: Augmentin ES-600 (600mg/42.9mg per 5ml) suspension (1350mg dose = approximately 11.25ml per dose)
When to Use High-Dose Regimen
The high-dose regimen (80-90mg/kg/day) should be used in the following situations:
- Severe infections
- Areas with high prevalence of resistant S. pneumoniae (>10%)
- Children younger than 2 years
- Children attending childcare
- Recent antibiotic treatment within the previous 30 days 1
Administration Guidelines
- Administer twice daily (every 12 hours)
- Give with food to improve gastrointestinal tolerability
- Complete the full course of treatment as prescribed (typically 5-10 days depending on the infection)
Monitoring and Safety
- Common side effects include diarrhea, nausea, and skin rash
- Diarrhea is generally less frequent with twice-daily dosing compared to three-times-daily dosing 2
- No dose adjustment is needed unless severe renal impairment is present (GFR <30 mL/min) 1
- Monitor for signs of allergic reaction or C. difficile infection
Alternative Options
For children with penicillin allergy:
- Macrolides (e.g., azithromycin, clarithromycin) can be used as alternatives 1
- Cephalosporins may be an option for non-severe, non-anaphylactic penicillin allergies
Clinical Reassessment
- Assess for clinical improvement within 48-72 hours
- If no improvement is seen, consider:
- Changing to an alternative antibiotic
- Reassessing the diagnosis
- Evaluating for complications
Remember that twice-daily dosing has been shown to provide comparable drug exposure to three-times-daily dosing for most common pathogens, which may improve adherence 1.