What is the appropriate dose of Augmentin (amoxicillin/clavulanic acid) for a child weighing 13.6 kg?

Augmentin Dosing for 13.6 kg Child

For a child weighing 13.6 kg, the standard Augmentin dose is 45 mg/kg/day of the amoxicillin component divided into two doses (22.5 mg/kg twice daily), which equals approximately 306 mg twice daily or 612 mg total daily dose. 1

Weight-Based Dosing Algorithm

For this specific weight (13.6 kg = 29.9 lbs):

• This child falls into the "less than 15 kg" category 1
• Standard dosing formulation (45/6.4 mg/kg/day): Administer approximately 306 mg of amoxicillin component twice daily 1, 2
• High-dose formulation (90/6.4 mg/kg/day): For recurrent/persistent infections or suspected resistant pathogens, administer approximately 612 mg of amoxicillin component twice daily 1

Practical Formulation Selection

Using the oral suspension (most common pediatric formulation):

• Standard concentration is typically 200 mg/5 mL or 400 mg/5 mL 1
• For 45 mg/kg/day dosing: Calculate 306 mg per dose
• For 90 mg/kg/day dosing: Calculate 612 mg per dose 1

Clinical Context for Dose Selection

Standard dose (45 mg/kg/day) is appropriate for: 1, 2

• First-line treatment of uncomplicated infections
• Urinary tract infections
• Skin and soft tissue infections
• Upper respiratory tract infections without recent antibiotic failure

High dose (90 mg/kg/day) should be used for: 1

• Recurrent or persistent acute otitis media after amoxicillin failure
• Suspected penicillin-intermediate or resistant Streptococcus pneumoniae (MIC ≤2 mg/L)
• Recent antibiotic exposure within past 30 days
• Daycare attendance or other risk factors for resistant pathogens

Administration Guidelines

• Administer twice daily dosing to minimize gastrointestinal side effects, particularly diarrhea 1, 2
• Give with meals to improve gastrointestinal tolerability 1
• Duration: Typically 5-10 days depending on infection type 1, 2

Common Pitfalls to Avoid

• Do not use three-times-daily dosing as it significantly increases diarrhea incidence compared to twice-daily administration 1
• Avoid underdosing in children with suspected resistant pathogens—use the high-dose formulation (90/6.4 mg/kg/day) rather than standard dose 1
• Do not exceed maximum daily doses: Standard formulation should not exceed adult dosing equivalents 1, 2
• Ensure proper reconstitution of oral suspension and shake well before each dose to maintain accurate dosing 1

Monitoring Considerations

• Watch for gastrointestinal disturbances (most common adverse effect: mild diarrhea, nausea, vomiting) 1, 2
• Assess clinical response within 48-72 hours; lack of improvement may indicate resistant pathogens requiring dose escalation or alternative therapy 1
• Monitor for hypersensitivity reactions, though these are uncommon 2, 3