Augmentin Dosing for a 78-pound Pediatric Patient
For a pediatric patient weighing 78 pounds (35.4 kg), the recommended dose of Augmentin (amoxicillin/clavulanate) is 45-90 mg/kg/day of the amoxicillin component divided into two doses, which equals approximately 800-1600 mg of amoxicillin per day. 1
Dosing Considerations
Standard Dosing
- For most common infections, the standard dose is 45 mg/kg/day of amoxicillin component divided into two doses 1
- For more severe infections or those with suspected resistant pathogens, the high-dose formulation of 90 mg/kg/day in two divided doses is recommended 2
Weight-Based Calculation
- At 78 pounds (35.4 kg):
- Standard dose (45 mg/kg/day): 1593 mg/day or approximately 800 mg twice daily
- High-dose (90 mg/kg/day): 3186 mg/day or approximately 1600 mg twice daily 3
Age-Based Considerations
- For children >5 years old (which likely applies to a 78-pound child), the standard dosing is typically 45 mg/kg/day divided into two doses 1
- For persistent or recurrent infections, especially acute otitis media with risk factors for resistant organisms, the high-dose formulation (90 mg/kg/day) is preferred 2
Formulation Selection
Available Formulations
- Oral suspensions: typically available as 200 mg/5mL, 400 mg/5mL, or 600 mg/5mL (ES-600 formulation) 2
- Tablets: available in various strengths including 500 mg and 875 mg (of amoxicillin component) 3
Recommended Administration
- For a child weighing 78 pounds who can swallow tablets:
Duration of Therapy
- For most respiratory tract infections: 7-10 days of therapy 1
- For otitis media: 10 days of therapy is typically recommended 2
- For more severe infections: treatment duration may be extended based on clinical response 1
Monitoring and Safety
- Most common adverse effects are mild gastrointestinal disturbances, particularly diarrhea 2
- Diarrhea is generally less frequent with twice-daily dosing compared to three-times-daily dosing 2
- No dosage adjustment is required for renal function in pediatric patients with normal kidney function 3
Clinical Pearls
- Twice-daily dosing has similar efficacy to three-times-daily dosing with better compliance and fewer gastrointestinal side effects 2
- Augmentin should be taken with food to minimize gastrointestinal side effects 3
- The high-dose formulation (ES-600) was specifically developed to treat infections caused by resistant pathogens, including penicillin-intermediate and resistant S. pneumoniae 3, 2
Remember that Augmentin should be dosed based on the amoxicillin component, with the clavulanic acid serving as a beta-lactamase inhibitor to extend the spectrum of activity against resistant organisms 3.