What is the appropriate dosage of Augmentin (amoxicillin/clavulanate) for a 140-pound adolescent?

Augmentin Dosing for a 140-pound Adolescent

For a 140-pound (63.5 kg) adolescent, the appropriate Augmentin (amoxicillin/clavulanate) dosage is 875 mg/125 mg twice daily. 1

Dosage Calculation

• Children weighing more than 40 kg should be dosed as adults 1
• A 140-pound adolescent weighs approximately 63.5 kg, which exceeds the 40 kg threshold for adult dosing 1
• For skin/skin structure or respiratory tract infections (common indications for Augmentin):
  • The recommended adult dose is 875 mg amoxicillin component every 12 hours 1, 2
  • This corresponds to the standard Augmentin formulation of 875 mg amoxicillin/125 mg clavulanate 1

Administration Guidelines

• Augmentin should be taken at the start of a meal to minimize gastrointestinal intolerance 1
• Treatment duration depends on the specific infection:
  • For most infections: continue for 48-72 hours beyond symptom resolution 1
  • For Streptococcus pyogenes infections: minimum 10-day treatment course to prevent acute rheumatic fever 1, 2

Alternative Dosing Options

• For less severe infections, 500 mg amoxicillin component every 8 hours can be considered 1
• If using the pediatric calculation method (though not necessary for this weight):
  • For mild/moderate infections: 25 mg/kg/day in divided doses every 12 hours 1
  • For severe infections: 45 mg/kg/day in divided doses every 12 hours 1

Maximum Dosage Considerations

• The maximum daily dose of amoxicillin for both adults and children is 4 grams per day 3
• For children, high-dose amoxicillin is defined as 90 mg/kg/day, not to exceed 4000 mg/day 3
• For this 63.5 kg adolescent, even at the highest pediatric dosing (90 mg/kg/day), the maximum would be 5715 mg/day, which exceeds the absolute maximum of 4000 mg/day 3

Clinical Considerations

• Augmentin provides coverage against beta-lactamase-producing pathogens due to the clavulanate component 4
• The twice-daily formulation (875/125 mg) improves compliance compared to three-times-daily dosing 4
• For severe infections or areas with high prevalence of resistant S. pneumoniae, the high-dose formulations may be considered, though standard dosing is appropriate for most community-acquired infections 4

Common Pitfalls to Avoid

• Exceeding the maximum daily dose of 4 grams of amoxicillin component, regardless of patient weight 3
• Inadequate duration of therapy, especially for streptococcal infections 1
• Failing to administer with food, which can increase gastrointestinal side effects 1
• Not adjusting dose in patients with severe renal impairment (GFR <30 mL/min) 1