What is the recommended dosing of Augmentin (amoxicillin/clavulanic acid) for a 10-month-old child weighing 18 pounds with a dog bite?

Augmentin Dosing for a 10-Month-Old with Dog Bite

For a 10-month-old child weighing 18 pounds (approximately 8.2 kg) with a dog bite, the recommended dosage of Augmentin (amoxicillin/clavulanic acid) is 40-45 mg/kg/day divided into two doses.

Dosage Calculation

• For children weighing less than 15 kg (33 lbs), dosing should be carefully calculated by weight rather than using standard fixed doses 1
• For this 8.2 kg child, the appropriate dosage would be approximately 45 mg/kg/day of the amoxicillin component, divided into two doses 1, 2
• This translates to approximately 185 mg of amoxicillin twice daily (total daily dose of 370 mg) 1
• The child should receive the pediatric formulation of Augmentin suspension, which contains a different amoxicillin to clavulanic acid ratio than adult tablets 1

Administration Guidelines

• Administer Augmentin at the start of a meal to enhance absorption of clavulanic acid and minimize gastrointestinal intolerance 1
• Use the provided measuring device to ensure accurate dosing 1
• The medication should be given at evenly spaced intervals (every 12 hours for twice-daily dosing) 1

Treatment Duration

• For dog bites, a typical course of 5-7 days is recommended, though this may be extended based on clinical response 2
• Observe for clinical improvement within 48-72 hours of starting therapy 2
• If symptoms worsen or do not improve within 72 hours, reevaluation is necessary 2

Clinical Considerations for Dog Bites

• Dog bites carry risk of polymicrobial infection including Pasteurella species, streptococci, staphylococci, and anaerobes 2
• Augmentin is particularly effective for dog bites due to its broad spectrum coverage of these organisms 2, 3
• Early treatment is crucial to prevent infection, especially for bites to the face, hands, or in immunocompromised patients 2

Monitoring

• Monitor for common side effects including diarrhea, diaper rash, and vomiting 2
• Diarrhea is generally less frequent with twice-daily than with three-times-daily treatment 2
• If severe diarrhea or allergic reactions occur, discontinue medication and seek immediate medical attention 2

Important Considerations

• Ensure the child is up-to-date on tetanus prophylaxis 2
• Proper wound cleansing and debridement are essential adjuncts to antibiotic therapy 2
• For deep puncture wounds or bites to the hand, face, or joint areas, consider evaluation for possible surgical intervention 2