What is the recommended dose of Amoxicillin (Amoxicillin) for a 10 Kg child with Acute Respiratory Infection (ARI)?

Amoxicillin Dosing for a 10 kg Child with Acute Respiratory Infection

For a 10 kg child with acute respiratory infection (ARI), the recommended dose of amoxicillin is 45 mg/kg/day divided into 2-3 doses, which equals approximately 450 mg per day or 150 mg three times daily. 1, 2

Dosing Recommendations

• For mild to moderate respiratory infections, amoxicillin should be dosed at 45 mg/kg/day divided into 2-3 doses 1
• For a 10 kg child, this equals 450 mg total daily dose, which can be given as:
  • 150 mg three times daily (every 8 hours) 2
  • OR 225 mg twice daily (every 12 hours) 3
• Treatment duration should typically be 7-10 days for respiratory infections 4, 2
• The medication should be taken at the start of a meal to minimize gastrointestinal intolerance 2

Clinical Considerations

• Amoxicillin is the first-line antibiotic for respiratory tract infections in children due to its effectiveness against common respiratory pathogens, particularly Streptococcus pneumoniae 1
• For areas with high pneumococcal resistance, higher dosing of 90 mg/kg/day may be warranted, which would be 900 mg daily or 300 mg three times daily for a 10 kg child 1
• The FDA-approved dosing for lower respiratory tract infections in children weighing less than 40 kg is 45 mg/kg/day divided into doses given every 12 hours or 40 mg/kg/day divided into doses given every 8 hours 2

Administration Guidelines

• Amoxicillin oral suspension should be shaken well before each use 2
• The required amount of suspension can be placed directly on the child's tongue or mixed with formula, milk, fruit juice, or water 2
• Any prepared suspension must be discarded after 14 days 2
• Refrigeration is preferable but not required 2

Important Considerations

• Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic 2
• For infections caused by Streptococcus pyogenes, a minimum of 10 days of treatment is recommended to prevent acute rheumatic fever 2
• Recent research suggests that shorter courses (3 days) may be as effective as longer courses (7 days) for uncomplicated respiratory infections, but this is still being studied 5
• Amoxicillin has a well-established safety profile in children, with gastrointestinal effects (diarrhea, nausea) being the most common adverse reactions 1

Remember to adjust the dose if the child has severe renal impairment, though this is uncommon in pediatric patients with simple ARI 2.