Amoxicillin Dosage for 5-Year-Old Children
For a 5-year-old child, the recommended dosage of amoxicillin is 45-90 mg/kg/day divided into 2 doses (every 12 hours) or 3 doses (every 8 hours), depending on the severity of infection. 1
Standard Dosing Recommendations
For mild to moderate infections (ear/nose/throat, skin/skin structure, genitourinary tract):
- 25 mg/kg/day divided every 12 hours OR
- 20 mg/kg/day divided every 8 hours 1
For severe infections or lower respiratory tract infections:
- 45 mg/kg/day divided every 12 hours OR
- 40 mg/kg/day divided every 8 hours 1
Specific Infection-Based Dosing
For Streptococcus pneumoniae infections:
- For susceptible S. pneumoniae (MICs <2.0 μg/mL):
- 90 mg/kg/day in 2 doses OR
- 45 mg/kg/day in 3 doses 2
For Group A Streptococcus:
- 50-75 mg/kg/day in 2 doses 2
For Haemophilus influenzae:
- If β-lactamase negative: 75-100 mg/kg/day in 3 doses
- If β-lactamase producing: amoxicillin-clavulanate with amoxicillin component at 45 mg/kg/day in 3 doses or 90 mg/kg/day in 2 doses 2
Administration Guidelines
- Administer at the start of a meal to minimize gastrointestinal intolerance 1
- For oral suspension:
- Shake well before using
- Can be placed directly on child's tongue or mixed with formula, milk, fruit juice, water, or cold drinks
- Any unused portion must be discarded after 14 days
- Refrigeration is preferable but not required 1
Duration of Treatment
- Treatment should continue for a minimum of 48-72 hours beyond the time that the patient becomes asymptomatic 1
- For Streptococcus pyogenes infections, a minimum of 10 days' treatment is recommended to prevent acute rheumatic fever 1
- For community-acquired pneumonia, shorter courses (5 days) may be as effective as longer courses (10 days) for uncomplicated cases 3
Dosing Considerations
- Higher doses (70-90 mg/kg/day) may be needed for areas with high prevalence of penicillin-resistant pneumococci 2
- Twice-daily dosing (higher dose per administration) may be a feasible alternative to three-times-daily dosing for improved compliance 4
- For severe infections, consider higher dosing at the upper end of the recommended range 1
Common Pitfalls and Caveats
- Dosing is weight-based, not age-based, so accurate weight measurement is essential 1
- Underdosing may lead to treatment failure, particularly in areas with antimicrobial resistance 4
- Children with renal impairment may require dose adjustment, though this is uncommon in otherwise healthy 5-year-olds 1
- Amoxicillin is often preferred over broader-spectrum antibiotics for common pediatric infections, but prescribing practices often favor broader agents unnecessarily 5
- For twice-daily dosing, consider 30-40 mg/kg/dose to ensure adequate time above MIC at higher concentration levels 4