Amoxicillin Dosage for a 14 kg Toddler
For a 14 kg toddler, the recommended amoxicillin dose is 630 mg per day (45 mg/kg/day) divided into two doses of 315 mg every 12 hours for mild to moderate infections, or 1260 mg per day (90 mg/kg/day) divided into two doses of 630 mg every 12 hours for severe infections or areas with high pneumococcal resistance. 1
Indication-Based Dosing
The appropriate dose depends on the type and severity of infection:
Mild to Moderate Infections
- Ear/nose/throat, skin, or genitourinary infections: 25 mg/kg/day divided every 12 hours (approximately 350 mg per day for 14 kg = 175 mg twice daily) 2
- Respiratory tract infections: 45 mg/kg/day divided into 2 doses (630 mg per day = 315 mg twice daily) 1
Severe Infections or High Resistance Areas
- Severe respiratory infections or high pneumococcal resistance: 90 mg/kg/day divided into 2 doses (1260 mg per day = 630 mg twice daily) 1
- Lower respiratory tract infections: 45 mg/kg/day divided every 12 hours (630 mg per day = 315 mg twice daily) 2
Specific Infections
- Group A Streptococcal infections (including scarlet fever): 50-75 mg/kg/day divided into 2 doses for 10 days (700-1050 mg per day = 350-525 mg twice daily, not exceeding 1000 mg per dose) 1
Administration Guidelines
- Take at the start of meals to minimize gastrointestinal intolerance 2
- Treatment duration: Continue for minimum 48-72 hours beyond symptom resolution 2
- Streptococcal infections require 10 days of treatment to prevent acute rheumatic fever 2
- Clinical improvement should occur within 48-72 hours; if not, reevaluation is necessary 1
Important Clinical Considerations
The higher dose (90 mg/kg/day) is specifically indicated when:
- Treating severe pneumonia or respiratory infections 1
- In geographic areas with high rates of penicillin-resistant Streptococcus pneumoniae 1
- When initial lower-dose therapy has failed 3
Common pitfalls to avoid:
- Underdosing in areas with resistant pathogens—current resistance patterns may require the higher 90 mg/kg/day regimen 4
- Stopping antibiotics when symptoms improve before completing the full course 1
- Using age-based rather than weight-based dosing, which can lead to subtherapeutic levels 5
Practical Dosing Example
For this 14 kg toddler:
- Standard dose: 315 mg twice daily (using 45 mg/kg/day)
- High dose: 630 mg twice daily (using 90 mg/kg/day)
- Maximum daily dose: Should not exceed 4000 mg/day 6, 1
The twice-daily regimen improves adherence compared to three-times-daily dosing and maintains adequate therapeutic levels 1, 7