What is the recommended dose of Amoxicillin (amoxicillin) for a 13.6 kg pediatric patient?

Amoxicillin Dosing for a 13.6 kg Pediatric Patient

For a 13.6 kg child, prescribe amoxicillin 45 mg/kg/day divided into two doses (approximately 306 mg twice daily) for mild to moderate infections, or 90 mg/kg/day divided into two doses (approximately 612 mg twice daily) for severe infections or areas with high pneumococcal resistance. 1

Standard Dosing Recommendations

Mild to Moderate Infections

• For respiratory tract infections including pneumonia, the recommended dose is 45 mg/kg/day divided every 12 hours 2, 1
• For a 13.6 kg child, this equals approximately 306 mg twice daily (612 mg total daily dose) 1
• This can be administered as 6.1 mL of 250 mg/5 mL suspension twice daily 3

Severe Infections or High Resistance Areas

• For severe respiratory infections or regions with high pneumococcal resistance, increase to 90 mg/kg/day divided every 12 hours 2, 1
• For a 13.6 kg child, this equals approximately 612 mg twice daily (1,224 mg total daily dose) 1
• This can be administered as 12.2 mL of 250 mg/5 mL suspension twice daily 3

Indication-Specific Dosing

Group A Streptococcal Infections

• The recommended dose is 50-75 mg/kg/day divided into 2 doses 1
• For a 13.6 kg child, this equals 340-510 mg twice daily 1
• Treatment duration should be 10 days to prevent acute rheumatic fever 3

Ear, Nose, Throat, Skin, and Genitourinary Infections

• Mild/moderate: 25 mg/kg/day divided every 12 hours (approximately 170 mg twice daily) 3
• Severe: 45 mg/kg/day divided every 12 hours (approximately 306 mg twice daily) 3

Administration Guidelines

Timing and Food

• Administer at the start of a meal to minimize gastrointestinal intolerance 3
• Shake oral suspension well before each use 3

Suspension Preparation

• Use the 250 mg/5 mL strength for easier dosing in this weight range 3
• After reconstitution, refrigeration is preferable but not required 3
• Discard any unused suspension after 14 days 3

Treatment Duration

Standard Course

• Continue treatment for a minimum of 48-72 hours beyond symptom resolution 3
• For most respiratory infections, 7-10 days is the standard duration 1
• For pneumonia specifically, 10 days of treatment is recommended 1

Monitoring Response

• Children on appropriate therapy should demonstrate clinical improvement within 48-72 hours 2, 1
• If no improvement occurs within this timeframe, reevaluation and further investigation are necessary 2, 1

Important Clinical Considerations

Advantages of Amoxicillin

• Better taste and improved adherence compared to penicillin V due to twice-daily dosing 1
• Excellent oral absorption and favorable tissue penetration 4

Common Adverse Effects

• Gastrointestinal disturbances (diarrhea, nausea, vomiting) are most common 1
• Rash, urticaria, and hypersensitivity reactions may occur 1
• Monitor for these effects and reassess if symptoms worsen 1

Critical Pitfalls to Avoid

• Do not use the 875 mg tablet formulation in children under 40 kg 3
• Ensure completion of the full antibiotic course even if symptoms improve early 1
• For suspected MRSA, amoxicillin alone is insufficient and alternative antibiotics should be considered 5

Example Prescription

For mild-moderate community-acquired pneumonia in a 13.6 kg child:

• Amoxicillin 250 mg/5 mL oral suspension
• Dose: 6 mL (300 mg) by mouth twice daily with meals
• Duration: 10 days
• Dispense: 120 mL bottle
• Shake well before use; refrigerate after opening; discard after 14 days