Appropriate Dosage of Augmentin 600/42.9 mg/5ml for a 4-Year-Old Child Weighing 38 Pounds
For a 4-year-old child weighing 38 pounds (17.2 kg), the appropriate dose of Augmentin (amoxicillin/clavulanate) 600/42.9 mg/5ml is 45 mg/kg/day of amoxicillin component in divided doses every 12 hours, which equals approximately 3.2 ml per dose given twice daily.
Dosage Calculation
- 38 pounds = 17.2 kg
- For mild to moderate infections: 45 mg/kg/day of amoxicillin component divided in two doses 1, 2
- Total daily dose: 17.2 kg × 45 mg/kg = 774 mg amoxicillin per day
- Per dose (twice daily): 774 mg ÷ 2 = 387 mg amoxicillin per dose
- Volume calculation: 387 mg ÷ (600 mg/5 ml) = 3.2 ml per dose
Dosing Schedule and Administration
- Administer 3.2 ml twice daily (every 12 hours) 2
- Give at the start of a meal to minimize gastrointestinal intolerance 2
- Shake the oral suspension well before using 2
- Continue treatment for a minimum of 48-72 hours beyond symptom resolution 2
- For Streptococcus pyogenes infections, complete a minimum of 10 days of treatment to prevent acute rheumatic fever 2
Clinical Considerations
- Augmentin 600/42.9 mg/5ml (also known as Augmentin ES-600) was specifically developed for pediatric use in persistent or recurrent acute otitis media with risk factors for drug-resistant pathogens 3
- The 600/42.9 mg/5ml formulation provides a 14:1 ratio of amoxicillin to clavulanate, allowing for higher amoxicillin doses while maintaining the same daily clavulanate exposure 4
- For severe infections, the dose may be increased to 90 mg/kg/day of amoxicillin component in two divided doses 1, 3
Storage and Preparation
- After reconstitution, refrigeration is preferable but not required 2
- Keep the bottle tightly closed 2
- Discard any unused portion of the reconstituted suspension after 14 days 2
Monitoring and Safety
- Common side effects include diarrhea, nausea, vomiting, and rash 3, 4
- Monitor for signs of allergic reactions or Clostridium difficile-associated diarrhea 2
- If the child has impaired renal function, dose adjustment may be necessary 2
Remember that this dosage recommendation is based on the child's weight and the specific formulation of Augmentin (600/42.9 mg/5ml). Always verify the concentration before administering the medication.