What is the recommended dose of amoxicillin (amoxicillin) for a 10-year-old child weighing 57kg with mild to moderate infection?

Amoxicillin Dosing for Group A Streptococcal Infection in a 10-Year-Old Child Weighing 57kg

For a 10-year-old child weighing 57kg with Group A streptococcal infection, the recommended dose of amoxicillin is 45 mg/kg/day divided into two doses (every 12 hours) for 10 days. 1

Dosing Calculation

Since the child weighs 57kg (which is over 40kg), the dosing follows the adult dosing recommendations according to the FDA label:

• For mild to moderate infections involving the ear/nose/throat (which includes Group A streptococcal pharyngitis):

  • 500mg every 12 hours or 250mg every 8 hours 1

• For severe infections:

  • 875mg every 12 hours or 500mg every 8 hours 1

Treatment Duration

• Treatment should continue for a minimum of 10 days for any infection caused by Streptococcus pyogenes (Group A strep) to prevent the occurrence of acute rheumatic fever 1

Important Administration Instructions

• Amoxicillin should be taken at the start of a meal to minimize potential gastrointestinal intolerance 1
• The medication should be continued for the full 10-day course, even if symptoms resolve earlier, to ensure complete bacterial eradication and prevent complications 1

Special Considerations

• When prescribing amoxicillin, the prescription should include:
  • The daily dose
  • Number of divided doses
  • Duration of therapy (10 days)
  • Indication for the prescription
  • Child's weight 2

Monitoring

• Clinical improvement should be assessed within 48-72 hours of starting treatment 3
• If no improvement is seen within this timeframe, reassessment is necessary to consider alternative treatments 3
• Signs of improvement include decreased fever and improved overall condition 3

Potential Pitfalls

1. Underdosing: Some clinicians may use age-based rather than weight-based dosing, which can lead to inadequate treatment, especially in larger children 2
2. Insufficient duration: Stopping treatment early (before 10 days) for Group A strep infections increases the risk of acute rheumatic fever 1
3. Poor adherence: Twice-daily dosing may improve compliance compared to three-times-daily dosing, with comparable efficacy 4

By following these evidence-based recommendations, you can ensure appropriate treatment of Group A streptococcal infection in this pediatric patient while minimizing the risk of complications and promoting adherence to the treatment regimen.