Amoxicillin Dosing for Preseptal Cellulitis in a 1-Year-Old Child
For a 1-year-old child with preseptal cellulitis, the recommended dose of amoxicillin is 45 mg/kg/day divided into doses every 12 hours for mild to moderate infections, or 90 mg/kg/day divided into doses every 12 hours for severe infections. 1
Dosing Considerations
Weight-Based Dosing
- For mild to moderate infections: 45 mg/kg/day divided every 12 hours
- For severe infections: 90 mg/kg/day divided every 12 hours 1
Assessment of Severity
Determine the severity of preseptal cellulitis based on:
- Extent of eyelid swelling and erythema
- Presence of fever
- Systemic symptoms
- Child's overall appearance
- Ability to maintain oral intake
Administration Guidelines
- Administer amoxicillin at the start of a meal to minimize gastrointestinal intolerance 1
- Treatment should continue for a minimum of 48-72 hours beyond symptom resolution 1
- Total treatment duration typically ranges from 7-10 days
Alternative Antibiotic Options
If the child has penicillin allergy or if there's concern for resistant organisms:
- Clindamycin: 10-13 mg/kg/dose every 6-8 hours (not to exceed 40 mg/kg/day) 2
- For severe infections requiring IV therapy: Consider ceftriaxone, cefotaxime, or ampicillin 2, 3
Monitoring Response
- Clinical improvement should be expected within 48-72 hours
- If no improvement occurs within this timeframe, reassess the diagnosis and consider:
- Alternative antibiotic therapy
- Imaging to rule out orbital involvement
- Possible surgical intervention if abscess formation
Important Considerations
- For children under 1 year, ensure proper dose calculation based on accurate weight
- Monitor for adverse effects including diarrhea, rash, or allergic reactions
- Ensure adequate hydration during treatment
- Complete the full course of antibiotics even if symptoms improve quickly
When to Consider Hospitalization
Consider inpatient management with IV antibiotics if:
- Child appears toxic or has systemic illness
- Inability to tolerate oral medications
- Rapid progression of infection
- Concern for orbital involvement
- Immunocompromised state
- Age less than 3 months
Remember that preseptal cellulitis in young children requires prompt treatment to prevent progression to orbital cellulitis, which can lead to serious complications including vision loss.