What is the recommended metronidazole (antibiotic) dosage for a patient weighing 14 kilograms (kg)?

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Metronidazole Dosing for a 14 kg Pediatric Patient

For a 14 kg child, administer metronidazole at 20-30 mg/kg/day, which translates to 280-420 mg per day, typically divided into 2-3 doses depending on the indication.

Weight-Based Calculation

  • The standard pediatric dose for children under 12 years is 20-30 mg/kg/day 1
  • For a 14 kg patient, this calculates to:
    • Minimum dose: 280 mg/day (14 kg × 20 mg/kg) 1
    • Maximum dose: 420 mg/day (14 kg × 30 mg/kg) 1

Dosing by Specific Indication

For Giardiasis

  • 40 mg/kg/day divided into three doses for 7 days 2
  • For a 14 kg child: 560 mg/day total, given as approximately 185-190 mg three times daily 2
  • Alternative regimen: 15 mg/kg/day for 5 days for giardiasis specifically 3
  • For a 14 kg child using the lower dose: 210 mg/day total, given as 70 mg three times daily 3

For Amebiasis

  • 30 mg/kg/day for 5-10 days 3
  • For a 14 kg child: 420 mg/day total, typically divided into three doses of 140 mg each 3

For Trichomoniasis (if applicable to pediatric cases)

  • Adult dosing is typically used for adolescents: 500 mg twice daily for 7 days or 2 g single dose 3
  • Pediatric-specific dosing for trichomoniasis is not well-established in the guidelines provided

Practical Dosing Intervals

  • Three times daily (every 8 hours) is the most common regimen for most indications 3, 2
  • Twice daily (every 12 hours) can be used for certain infections, particularly when using higher total daily doses 1

Duration of Therapy

  • Giardiasis: 5-7 days 3, 2
  • Amebiasis: 5-10 days 3
  • General parasitic infections: 7 days minimum 2

Important Clinical Caveats

  • The 20-30 mg/kg/day range is for general use; specific infections may require higher doses up to 40 mg/kg/day 2
  • Maximum daily dose should not exceed 2000 mg even in older children 1
  • Side effects are generally mild and tolerable at these pediatric doses 4, 2
  • Ensure adequate hydration during treatment 2
  • For severe or complicated infections, consider using the higher end of the dosing range (30 mg/kg/day or 40 mg/kg/day depending on indication) 1, 2

References

Research

The efficacy of metronidazole in the treatment of giardiasis.

The Southeast Asian journal of tropical medicine and public health, 1982

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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