Co-amoxiclav Dosing for 7-Year-Old Female, 18 kg
For this 7-year-old child weighing 18 kg, give 5 ml of co-amoxiclav 250/62 suspension three times daily (every 8 hours). 1, 2
Dosing Calculation and Rationale
Age-Based Guideline Recommendation
- Children aged 7-12 years should receive 5 ml of 250/62 suspension three times daily, which is the standard regimen for this age group 1, 2
- This age-based dosing is specifically recommended for pediatric patients in pandemic influenza guidelines and general pediatric infectious disease management 1
Weight-Based Verification
- The 457 mg/5ml formulation you mentioned appears to be a high-dose formulation (approximately 400 mg amoxicillin + 57 mg clavulanate per 5 ml) 3, 4
- For standard dosing (45 mg/kg/day): 18 kg × 45 mg/kg/day = 810 mg/day ÷ 3 doses = 270 mg per dose 5, 2
- For high-dose regimen (90 mg/kg/day): 18 kg × 90 mg/kg/day = 1620 mg/day ÷ 2 doses = 810 mg per dose 5, 6, 2
Practical Dosing with 457 mg/5ml Suspension
If using the 457 mg/5ml formulation (high-dose formulation):
- For standard three-times-daily dosing: Give approximately 3 ml every 8 hours (provides ~274 mg amoxicillin per dose, total ~822 mg/day) 2
- For high-dose twice-daily dosing: Give approximately 4.5 ml every 12 hours (provides ~411 mg amoxicillin per dose, total ~822 mg/day) 5, 2
Clinical Context Matters
Standard dosing (45 mg/kg/day in 3 divided doses) is appropriate for: 2
- Uncomplicated respiratory tract infections
- Urinary tract infections
- Skin and soft tissue infections
High-dose regimen (90 mg/kg/day in 2 divided doses) is indicated for: 6, 2
- Areas with high penicillin-resistant Streptococcus pneumoniae prevalence (>10%)
- Children <2 years with acute otitis media
- Recent antibiotic use within past 30 days
- Daycare attendance
- Moderate to severe illness
- Incomplete Haemophilus influenzae type b vaccination
Maximum Dose Considerations
- The maximum daily dose should not exceed 4000 mg of amoxicillin component regardless of weight 5, 6
- For this 18 kg child, calculated doses are well below the maximum threshold 5
Important Clinical Caveats
- The 14:1 ratio formulation (high-dose) causes less diarrhea than other amoxicillin-clavulanate preparations while maintaining efficacy 2
- Children on appropriate antibiotic therapy should show clinical improvement within 48-72 hours; if not, reevaluation is necessary 6
- Complete the full course of antibiotics as prescribed, typically 7-10 days for most pediatric infections 2