Daily Volume Calculation for Amoxicillin 125mg/5mL Suspension in Acute Otitis Media
For a child with acute otitis media receiving amoxicillin 125mg/5mL suspension, the daily volume depends on the child's weight and whether high-dose therapy is indicated, ranging from approximately 7-36 mL per day in two divided doses.
Standard Dosing Calculation
For children at low risk (no recent antibiotics, no daycare attendance, age >2 years), the standard dose is 40 mg/kg/day divided into 2 doses 1:
- Using 125mg/5mL suspension, this equals 1.6 mL per kg per day
- For example, a 15 kg child would receive 24 mL daily (12 mL twice daily)
- A 10 kg child would receive 16 mL daily (8 mL twice daily)
High-Dose Regimen Calculation
For children with risk factors (age <2 years, daycare attendance, recent antibiotic use within 30 days, concurrent conjunctivitis, or moderate-to-severe illness), high-dose therapy of 80-90 mg/kg/day in 2 divided doses is recommended 1, 2, 3:
- Using 125mg/5mL suspension at 90 mg/kg/day, this equals 3.6 mL per kg per day
- For a 15 kg child: 54 mL daily (27 mL twice daily)
- For a 10 kg child: 36 mL daily (18 mL twice daily)
Critical Dosing Considerations
The 125mg/5mL concentration is appropriate for standard-dose therapy but becomes impractical for high-dose regimens due to large volumes required 2, 3. When high-dose therapy is indicated:
- Consider using a higher concentration suspension (e.g., 250mg/5mL or 400mg/5mL) to reduce volume 2
- The high-dose regimen achieves middle ear fluid concentrations adequate to overcome penicillin-resistant S. pneumoniae 3
- Using standard doses when high-dose therapy is indicated leads to treatment failure with resistant organisms 3
Treatment Duration
The recommended treatment duration is 5 days for uncomplicated acute otitis media 1. This shorter duration is as effective as 10 days in most cases while reducing adverse effects and improving compliance 2.
Common Pitfall to Avoid
Always verify the suspension concentration before calculating volume 2, 3. The 125mg/5mL concentration differs significantly from 250mg/5mL or 400mg/5mL formulations, and confusion between concentrations is a frequent dosing error that can result in either subtherapeutic dosing (promoting resistance) or overdosing (increasing adverse effects).