What is the typical dosage of Amoxicillin (amoxicillin) for a 40 kg toddler?

Amoxicillin Prescription for a 40 kg Toddler

For a 40 kg child (which is actually quite large for a toddler and more typical of a school-age child), prescribe amoxicillin 500 mg orally every 12 hours for mild to moderate infections, or 875 mg orally every 12 hours for severe infections or lower respiratory tract infections. 1

Weight-Based Dosing Considerations

The term "toddler" typically refers to children aged 1-3 years, who usually weigh 10-15 kg. A 40 kg child is more consistent with a 10-12 year old. However, I will provide guidance for this specific weight:

For Children ≥40 kg (Adult Dosing Applies)

According to FDA labeling, once a child reaches 40 kg, they transition to adult dosing regimens 1:

Mild to Moderate Infections (Ear/Nose/Throat, Skin/Skin Structure, Genitourinary Tract):

• 500 mg orally every 12 hours OR
• 250 mg orally every 8 hours 1

Severe Infections (Ear/Nose/Throat, Skin/Skin Structure, Genitourinary Tract):

• 875 mg orally every 12 hours OR
• 500 mg orally every 8 hours 1

Lower Respiratory Tract Infections (Mild, Moderate, or Severe):

• 875 mg orally every 12 hours OR
• 500 mg orally every 8 hours 1

Example Prescriptions

For Community-Acquired Pneumonia or Respiratory Infection:

Rx: Amoxicillin 875 mg tablets
Sig: Take 1 tablet by mouth every 12 hours for 10 days
Disp: 20 tablets
Indication: Community-acquired pneumonia
Patient weight: 40 kg

1

For Mild Otitis Media or Pharyngitis:

Rx: Amoxicillin 500 mg tablets
Sig: Take 1 tablet by mouth every 12 hours for 10 days
Disp: 20 tablets
Indication: Acute otitis media
Patient weight: 40 kg

1

Critical Prescribing Elements

Every antibiotic prescription should include 2:

• Daily dose and frequency
• Duration of therapy (minimum 10 days for Streptococcus pyogenes to prevent rheumatic fever) 1
• Indication for prescription
• Child's weight

Administration Instructions

• Take with food to minimize gastrointestinal intolerance 1
• Continue treatment for 48-72 hours beyond symptom resolution or evidence of bacterial eradication 1
• For Streptococcus pyogenes infections, minimum 10 days of treatment is mandatory to prevent acute rheumatic fever 1

Important Caveats

Renal Impairment: If the child has severe renal impairment (GFR <30 mL/min), do NOT use the 875 mg dose. Use 500 mg or 250 mg every 12 hours instead 1

Resistant Organisms: If treating infections in areas with high pneumococcal resistance or suspected resistant pathogens, consider higher-dose amoxicillin-clavulanate (90 mg/kg/day of amoxicillin component) rather than amoxicillin alone 3, 4, 5