What is the recommended dose of Augmentin (amoxicillin/clavulanic acid) for a patient weighing 29.2 pounds?

Augmentin Dosing for a 29.2 lb (13.3 kg) Patient

For a patient weighing 29.2 pounds (13.3 kg), the recommended Augmentin dose depends on infection severity: for mild-to-moderate infections, give 25 mg/kg/day of the amoxicillin component divided every 12 hours (approximately 165 mg twice daily), or for severe infections and lower respiratory tract infections, give 45 mg/kg/day divided every 12 hours (approximately 300 mg twice daily). 1

Weight-Based Dosing Calculations

• Patient weight: 29.2 lb = 13.3 kg 1

• Mild-to-moderate infections (ear/nose/throat, skin/skin structure, genitourinary tract):

  • 25 mg/kg/day divided every 12 hours = 165 mg twice daily 1
  • Alternative: 20 mg/kg/day divided every 8 hours = 88 mg three times daily 1

• Severe infections or lower respiratory tract infections:

  • 45 mg/kg/day divided every 12 hours = 300 mg twice daily 1
  • Alternative: 40 mg/kg/day divided every 8 hours = 177 mg three times daily 1

Practical Formulation Selection

• Use oral suspension formulations for this pediatric patient, as children at this age typically cannot swallow tablets reliably 2

• Available suspension strengths include 125 mg/5 mL and 250 mg/5 mL 1

• For mild-to-moderate infections using 125 mg/5 mL suspension: give 6.6 mL twice daily (165 mg dose) 1

• For severe infections using 250 mg/5 mL suspension: give 6 mL twice daily (300 mg dose) 1

Administration Guidelines

• Administer at the start of meals to minimize gastrointestinal intolerance and enhance clavulanate absorption 1, 3

• The suspension can be mixed with formula, milk, fruit juice, water, ginger ale, or cold drinks if needed, but must be taken immediately after mixing 1

• Shake the suspension well before each use and refrigerate after reconstitution (though not required) 1

• Discard any unused suspension after 14 days 1

Treatment Duration Considerations

• Continue treatment for minimum 48-72 hours beyond symptom resolution or evidence of bacterial eradication 1

• For streptococcal infections specifically, treat for at least 10 days to prevent acute rheumatic fever, regardless of clinical improvement 1

• For respiratory infections, typical duration is 5-7 days if clinically stable 4

Critical Dosing Warnings

• Do NOT substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet in older children, as this results in excessive clavulanate dosing 3

• This patient at 29.2 lb (13.3 kg) should NOT receive tablet formulations—use suspension only 3

• Ensure accurate weight-based dosing, as underdosing may lead to treatment failure and resistance development, particularly with resistant pathogens like penicillin-resistant Streptococcus pneumoniae 5

High-Dose Considerations

• For recurrent or persistent infections where resistant pathogens are suspected (particularly penicillin-resistant S. pneumoniae), high-dose formulation at 90 mg/kg/day divided twice daily may be indicated 5

• This would equal 600 mg twice daily for this 13.3 kg patient, using the ES-600 formulation specifically designed for resistant organisms 5

• High-dose formulations show similar tolerability to conventional doses but provide better coverage for penicillin MICs up to 2 mg/L 5