From the Guidelines
Augmentin (amoxicillin-clavulanate) is an appropriate antibiotic choice for treating community-acquired pneumonia in children, as it provides coverage against common respiratory pathogens, including beta-lactamase producing strains. According to the guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America 1, Augmentin is recommended as oral therapy for mild infections or step-down therapy, with a preferred dose of 45 mg/kg/day of the amoxicillin component in 3 doses or 90 mg/kg/day in 2 doses. The guidelines emphasize the importance of considering local susceptibility data when selecting antibiotic therapy.
Key points to consider when prescribing Augmentin for pediatric pneumonia include:
- The standard dosing for children is 45-90 mg/kg/day of the amoxicillin component, divided into two or three doses, typically given for 5-7 days for mild to moderate pneumonia and up to 10 days for more severe cases.
- Common formulations include liquid suspensions of varying strengths (200 mg/5mL, 400 mg/5mL, 600 mg/5mL) and tablets (500/125 mg, 875/125 mg).
- Side effects may include diarrhea, nausea, and rash.
- It's essential to complete the full course of antibiotics even if symptoms improve before finishing.
- If the child has a penicillin allergy, alternative antibiotics should be considered, such as azithromycin or clarithromycin, as outlined in the guidelines 1.
- Adequate hydration and fever control with acetaminophen or ibuprofen are important supportive measures during treatment.
- If symptoms worsen despite treatment or the child develops increased work of breathing, decreased oral intake, or lethargy, immediate medical reevaluation is necessary.
From the Research
Efficacy of Augmentin in Treating Pneumonia in Children
- Augmentin (amoxicillin/clavulanate) is a broad-spectrum antibacterial agent that has been used to treat community-acquired respiratory tract infections, including pneumonia, for over 20 years 2.
- A study published in 1989 compared the efficacy of amoxicillin and amoxicillin plus clavulanic acid (Augmentin) in the treatment of bacterial pneumonia in children, and found that the combination group had a significantly better response to treatment, with an excellent or good response recorded in 60% and 30% of patients, compared with 26% and 36% in the amoxicillin group 3.
- Another study published in 2006 suggested that penicillins, such as amoxicillin, remain effective in treating pneumococcal pneumonia, despite increasing resistance rates, and that beta-lactam antibiotics should continue to be used as first-line treatment for community-acquired pneumonia 4.
- A prospective and comparative study published in 1998 found that amoxicillin-clavulanic acid was an effective treatment for community-acquired pneumonia, with a recovery rate of 92.2% and no statistically significant differences in outcomes compared with cefuroxime or ceftriaxone 5.
Safety and Tolerance of Augmentin in Children
- Augmentin has a well-known safety and tolerance profile, with a low propensity to select resistance mutations and a favorable pharmacokinetic/pharmacodynamic profile predictive of high bacteriological efficacy 2.
- The study published in 1989 reported only two adverse reactions, one case each of skin rash and diarrhea, in the combination group 3.
- The study published in 1998 found that amoxicillin-clavulanic acid was well-tolerated, with no significant differences in adverse events compared with cefuroxime or ceftriaxone 5.
Guidelines and Recommendations for Augmentin Use in Children
- Augmentin is included in guidelines and recommendations for the treatment of bacterial sinusitis, acute otitis media, community-acquired pneumonia, and acute exacerbations of chronic bronchitis 2.
- The American Academy of Pediatrics recommends amoxicillin-clavulanic acid as a treatment option for community-acquired pneumonia in children, particularly for those with risk factors for beta-lactamase-producing pathogens or Streptococcus pneumoniae with reduced penicillin susceptibility.