What is the appropriate dosing of Amoxicillin (Augmentin) for pediatric patients in pill form?

From the Guidelines

The appropriate dosing of Amoxicillin (Augmentin) for pediatric patients in pill form is 90 mg/kg/day in 2 doses or 45 mg/kg/day in 3 doses, as recommended for the treatment of Streptococcus pneumoniae with MICs for penicillin >2.0 lg/mL 1.

Key Considerations

• The dosing of Amoxicillin (Augmentin) for pediatric patients depends on the child's weight and the specific infection being treated.
• For most common infections, the standard dose is based on the severity of the infection and the specific pathogen involved.
• The American Academy of Pediatrics and the Infectious Diseases Society of America provide guidelines for the treatment of community-acquired pneumonia in infants and children older than 3 months of age, which include recommendations for Amoxicillin (Augmentin) dosing 1.

Important Details

• The dose of 90 mg/kg/day in 2 doses is recommended for the treatment of Streptococcus pneumoniae with MICs for penicillin >2.0 lg/mL.
• The dose of 45 mg/kg/day in 3 doses may be used as an alternative for less severe infections.
• Augmentin tablets come in several strengths, including 250 mg, 500 mg, and 875 mg (referring to the amoxicillin component), and the appropriate tablet strength should be selected based on the child's weight.
• Children weighing at least 40 kg (88 pounds) can typically take the adult dosage.

Administration and Duration

• Augmentin should be taken with food to reduce stomach upset and improve absorption.
• The duration of treatment is typically 7-10 days, depending on the infection, and it's essential to complete the full course of antibiotics even if symptoms improve before finishing.
• The clavulanate component in Augmentin inhibits beta-lactamase enzymes that some bacteria produce to resist amoxicillin, making this combination effective against a broader spectrum of infections than amoxicillin alone.

From the FDA Drug Label

1. 2 Dosage for Adults and Pediatric Patients Aged 3 Months (12 weeks) and Older Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained It is recommended that there be at least 10 days’ treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever. In some infections, therapy may be required for several weeks. It may be necessary to continue clinical and/or bacteriological follow-up for several months after cessation of therapy. Table 1 (12 weeks) n 40 kg Recommended Dosage for Pediatric Patients Aged 3 Months and Older and Weight Less than 40 kg Ear/Nose/Throat Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours Severe 875 mg every 12 hours or 500 mg every 8 hours 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours

The appropriate dosing of Amoxicillin (Augmentin) for pediatric patients in pill form is as follows:

• For pediatric patients aged 3 months and older and weighing less than 40 kg:
  • Mild/Moderate infections: 500 mg every 12 hours or 250 mg every 8 hours, or 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours
  • Severe infections: 875 mg every 12 hours or 500 mg every 8 hours, or 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours 2

From the Research

Dosing of Amoxicillin (Augmentin) for Pediatric Patients

• The appropriate dosing of Amoxicillin (Augmentin) for pediatric patients in pill form is as follows:
  • Conventional formulations: 40/10 mg/kg/day in three divided doses 3
  • High-dose formulation: 90/6.4 mg/kg/day in two divided doses, for use in persistent or recurrent acute otitis media where there are risk factors for the involvement of beta-lactamase-producing strains or S. pneumoniae with reduced penicillin susceptibility 3, 4
  • Twice-daily formulation: 45/6.4 mg/kg/day, which has been shown to be effective and well-tolerated in the treatment of acute otitis media in children 5
• It is essential to consider individualized pharmacokinetic parameters, such as age, size, and level of organ maturity, when selecting a medication and dose for pediatric patients 6
• The dosing regimen should be based on the specific clinical diagnosis and the presence of risk factors for resistant pathogens, such as beta-lactamase-producing strains or S. pneumoniae with reduced penicillin susceptibility 3, 4