Dosing of Augmentin 600mg/5ml for a 265-pound Female with Strep Throat
For a 265-pound (120.2 kg) adult female with streptococcal pharyngitis who cannot take pills, the appropriate dose of Augmentin 600mg/5ml suspension is 15 ml twice daily for 10 days.
Dosage Calculation and Rationale
The dosing recommendation is based on the following considerations:
- For adults with streptococcal pharyngitis, the standard amoxicillin-clavulanate dosing is 875 mg amoxicillin/125 mg clavulanate twice daily 1
- The 600mg/5ml suspension refers to 600mg of amoxicillin component per 5ml
- For a 265-pound (120.2 kg) adult:
- 15 ml of the 600mg/5ml suspension provides 1800mg of amoxicillin per dose
- This higher dose is appropriate for this patient's weight and ensures adequate coverage for potential resistant strains
Administration Guidelines
- The suspension should be taken at the start of a meal to minimize gastrointestinal intolerance 2
- The full 10-day course must be completed even if symptoms improve before completion 1
- The suspension should be shaken well before each use
Treatment Duration
The Infectious Diseases Society of America (IDSA) guidelines strongly recommend a full 10-day course of therapy for streptococcal pharyngitis to prevent complications such as acute rheumatic fever 3. This duration recommendation has strong evidence support (strength of recommendation: strong, quality of evidence: high).
Special Considerations
Weight-based considerations: While pediatric dosing is typically weight-based, adult dosing for Augmentin is generally standardized. However, for a patient weighing 265 pounds, the higher dose (15ml of 600mg/5ml twice daily) ensures adequate drug levels.
Potential side effects: The most common adverse effects are gastrointestinal disturbances including diarrhea, nausea, and vomiting. Taking the medication with food can help minimize these effects 2.
Monitoring: No specific monitoring is required for this medication in patients with normal renal function.
Alternative Options
If the patient experiences significant gastrointestinal side effects with Augmentin, alternative options for streptococcal pharyngitis include:
- Clindamycin 300-450 mg orally three times daily for 10 days 3
- Azithromycin 500 mg on day 1, followed by 250 mg for 4 additional days (for patients >45 kg) 3
However, Augmentin is preferred for this patient due to its excellent coverage of streptococcal infections and potential beta-lactamase producing organisms that might be present.
Important Pitfalls to Avoid
- Underdosing: Insufficient dosing may lead to treatment failure and potential complications of streptococcal pharyngitis
- Premature discontinuation: Stopping therapy before completing the full 10-day course increases the risk of recurrence and complications
- Inadequate reconstitution: The suspension must be properly reconstituted and shaken well before each use to ensure accurate dosing