Amoxicillin Dosage for a 54-Pound Patient
For a 54-pound (approximately 24.5 kg) child, the recommended amoxicillin dosage is 40-50 mg/kg/day divided into 2-3 doses, which equals approximately 980-1225 mg per day or 325-408 mg per dose given three times daily. 1
Dosage Calculation Based on Weight and Indication
- The FDA-approved amoxicillin dosage for children weighing less than 40 kg is 20-40 mg/kg/day divided into doses every 8 hours for mild to moderate infections, and 40-45 mg/kg/day divided into doses every 8-12 hours for severe infections 1
- For most common pediatric infections, including ear/nose/throat and skin/skin structure infections, the recommended dosage is 25 mg/kg/day divided every 12 hours or 20 mg/kg/day divided every 8 hours for mild/moderate infections 1
- For severe infections or lower respiratory tract infections, the recommended dosage is 45 mg/kg/day divided every 12 hours or 40 mg/kg/day divided every 8 hours 1
- For Group A Streptococcal infections, amoxicillin should be given at 50-75 mg/kg/day in 2 doses 2
Specific Dosing Recommendations by Infection Type
For Streptococcal Pharyngitis
- Amoxicillin 50 mg/kg once daily (maximum = 1,000 mg) or 25 mg/kg twice daily (maximum = 500 mg) for 10 days 2
- Treatment should continue for a minimum of 10 days for any infection caused by Streptococcus pyogenes to prevent acute rheumatic fever 1
For Skin and Soft Tissue Infections
- For mild to moderate skin infections, 40 mg/kg/day divided into three doses is appropriate 3
- For a 24.5 kg child, this equals approximately 980 mg/day or about 325 mg per dose given three times daily 3
For Otitis Media and Respiratory Infections
- Higher doses (75-90 mg/kg/day) may be needed for acute otitis media, particularly when dealing with resistant organisms 4
- For community-acquired pneumonia, 35-50 mg/kg/day has been shown to be non-inferior to higher doses (70-90 mg/kg/day) 5
Administration Considerations
- Amoxicillin should be taken at the start of a meal to minimize gastrointestinal intolerance 1
- For oral suspension, the medication should be shaken well before using 1
- Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic 1
Dosing Frequency Options
- Twice-daily dosing (every 12 hours) has been shown to be a feasible alternative to three-times-daily dosing in many cases 6, 7
- For twice-daily dosing, consider using 45 mg/kg/day divided into two doses 1
- For three-times-daily dosing, use 40 mg/kg/day divided into three doses 1
Common Pitfalls and Caveats
- Underdosing amoxicillin may lead to treatment failure, particularly with resistant Streptococcus pneumoniae 4
- The current standard amoxicillin dosing of 40 mg/kg/day may be inadequate for resistant organisms, particularly during viral coinfection 4
- Any unused portion of reconstituted suspension must be discarded after 14 days 1
- Refrigeration of the reconstituted suspension is preferable but not required 1
For this 54-pound (24.5 kg) patient, the appropriate dosage would depend on the specific infection being treated, but for most common pediatric infections, 325-408 mg per dose given three times daily would be appropriate.