What is the recommended dose of Augmentin (amoxicillin/clavulanate) for a child weighing 108 pounds?

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Augmentin Dosing for a 108-Pound Child

For a child weighing 108 pounds (49 kg), the recommended dose of Augmentin is 875 mg twice daily for most infections, or up to 2000 mg twice daily for severe respiratory infections or drug-resistant pathogens. 1

Weight-Based Dosing Calculation

  • A 108-pound child weighs approximately 49 kg, which exceeds the 40 kg threshold where adult dosing applies 1

  • For children weighing more than 40 kg, standard adult dosing regimens should be used 1

Standard Dosing Recommendations by Severity

Mild to Moderate Infections

  • 500 mg every 12 hours or 250 mg every 8 hours for ear/nose/throat, skin/skin structure, or genitourinary tract infections 1

Severe Infections

  • 875 mg every 12 hours or 500 mg every 8 hours for severe infections of the ear/nose/throat, skin/skin structure, or genitourinary tract 1

Lower Respiratory Tract Infections

  • 875 mg every 12 hours or 500 mg every 8 hours for both mild/moderate and severe lower respiratory tract infections 1

High-Dose Formulations for Resistant Pathogens

  • For areas with high pneumococcal resistance or drug-resistant Streptococcus pneumoniae, a pharmacokinetically enhanced formulation of 2000 mg/125 mg twice daily (Augmentin XR) is available for adults and children over 40 kg 2

  • The maximum daily dose of the amoxicillin component should not exceed 4000 mg (4 g) per day 3

Administration Guidelines

  • Augmentin should be taken at the start of a meal to minimize gastrointestinal intolerance 1

  • Treatment should continue for a minimum of 48-72 hours beyond symptom resolution 1

  • For Streptococcus pyogenes infections, at least 10 days of treatment is required to prevent acute rheumatic fever 1

Duration of Therapy

  • Most respiratory tract infections require 7-10 days of therapy, with pneumonia specifically requiring 10 days 3, 4

  • Children on appropriate therapy should demonstrate clinical improvement within 48-72 hours; if no improvement occurs, reevaluation is necessary 3

Important Clinical Considerations

  • This child's weight places them in the adult dosing category, eliminating the need for weight-based calculations used in smaller children 1

  • The 875 mg tablet formulation is the most practical option for this weight range, avoiding the need for multiple tablets or large volumes of suspension 1

  • Renal function should be assessed if there are concerns about kidney impairment, as patients with glomerular filtration rate less than 30 mL/min should NOT receive the 875 mg dose 1

References

Guideline

Amoxicillin Dosing Guidelines for Pediatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Augmentin Dosing Guidelines for Pediatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 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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