What is the typical duration and dosage of Augmentin (amoxicillin-clavulanate) for a child with a respiratory infection?

Duration and Dosage of Augmentin for Pediatric Respiratory Infections

For most pediatric respiratory infections, Augmentin should be given for 7-10 days, with pneumonia specifically requiring 10 days of treatment. 1, 2, 3

Treatment Duration by Infection Type

For community-acquired pneumonia: Treatment should continue for 10 days when using beta-lactam antibiotics like Augmentin. 1 This duration is specifically recommended for pneumococcal pneumonia in children and should not be shortened even if symptoms improve earlier. 2

For bronchitis and other respiratory tract infections: The standard duration is 5-8 days for children under 3 years of age when fever persists beyond 3 days. 1 However, 7-10 days is the preferred minimum duration to ensure adequate bacterial eradication and prevent treatment failure. 2, 3, 4

Clinical improvement should be evident within 48-72 hours of starting treatment; if no improvement occurs, reassessment and potential change in therapy is necessary. 2, 3

Dosage Recommendations

For Children Under 5 Years (Pneumonia)

The standard dose is 80 mg/kg/day of the amoxicillin component, divided into appropriate intervals. 1

• Augmentin is specifically indicated when the child has inadequate H. influenzae type b vaccination (less than 3 injections) or concurrent purulent acute otitis media. 1
• Without these risk factors, plain amoxicillin at 80-100 mg/kg/day is preferred over Augmentin. 1

For Severe Infections or High-Resistance Areas

The dose should be increased to 90 mg/kg/day of the amoxicillin component, divided into 2 doses daily, with a maximum of 4000 mg (4 g) per day. 2

For Children 3 Months and Older Weighing Less Than 40 kg

Mild to moderate infections: 25 mg/kg/day divided every 12 hours or 20 mg/kg/day divided every 8 hours. 4

Severe infections or lower respiratory tract infections: 45 mg/kg/day divided every 12 hours or 40 mg/kg/day divided every 8 hours. 4

For Infants Under 3 Months

Maximum dose is 30 mg/kg/day divided every 12 hours due to immature renal function affecting drug elimination. 4 Treatment should continue for at least 48-72 hours beyond symptom resolution. 4

Critical Considerations and Common Pitfalls

Always complete the full prescribed course even if the child appears clinically improved before completion, as premature discontinuation increases risk of treatment failure and resistance development. 2

Augmentin is NOT first-line for most pediatric pneumonia. Plain amoxicillin is the reference treatment for pneumococcal pneumonia in children. 1 Augmentin should be reserved for specific situations: inadequate H. influenzae vaccination, concurrent purulent otitis media, or suspected beta-lactamase-producing organisms. 1

For children over 3 years with atypical pneumonia features (suggesting Mycoplasma or Chlamydia), macrolides are preferred over Augmentin. 1

Underdosing is a common prescribing error - ensure accurate weight-based calculations, particularly in severe infections where higher dosing (90 mg/kg/day) may be warranted. 2

Monitor for gastrointestinal side effects (diarrhea, nausea, vomiting) and hypersensitivity reactions (rash, urticaria), which are the most common adverse effects. 2, 3

Administer at the start of meals to minimize gastrointestinal intolerance. 4