What is the recommended dosage of Augmentin (amoxicillin/clavulanate) for a 2-year-old patient weighing 27 pounds?

Augmentin Dosage for a 2-Year-Old Weighing 27 Pounds

For a 2-year-old child weighing 27 pounds (12.3 kg), the recommended Augmentin dosage is 275 mg of amoxicillin component twice daily (approximately 6.9 mL of the 200 mg/5 mL suspension) for mild to moderate infections, or 550 mg twice daily (approximately 13.8 mL of the 200 mg/5 mL suspension) for severe infections or in areas with high pneumococcal resistance. 1

Weight-Based Dosing Calculation

This child falls into the ≤15 kg (≤33 lb) weight category for Augmentin dosing. 2

Standard Dosing Options:

For mild to moderate infections:

• 45 mg/kg/day divided twice daily using the every 12-hour regimen 1, 2
• Calculation: 12.3 kg × 45 mg/kg/day = 554 mg/day total, divided into 275 mg twice daily
• Administer 6.9 mL of the 200 mg/5 mL suspension twice daily 1

For severe infections or high-resistance areas:

• 90 mg/kg/day divided twice daily 1, 2
• Calculation: 12.3 kg × 90 mg/kg/day = 1,107 mg/day total, divided into 550 mg twice daily
• Administer 13.8 mL of the 200 mg/5 mL suspension twice daily 1

Formulation Selection

The 200 mg/5 mL or 400 mg/5 mL oral suspension formulations are recommended for this age group, as the every 12-hour regimen is associated with significantly less diarrhea compared to every 8-hour dosing. 2

The FDA label specifies that for patients aged 12 weeks (3 months) and older, the every 12-hour regimen should be preferred over the every 8-hour regimen due to reduced gastrointestinal side effects. 2

Treatment Duration and Administration

Treatment duration should be 10 days for acute otitis media and 7-10 days for other respiratory infections. 1, 2

Administer at the start of meals to minimize gastrointestinal intolerance and enhance absorption of clavulanate. 2

Clinical Monitoring

Clinical improvement should be expected within 48-72 hours of initiating therapy. 1, 3 If no improvement occurs within this timeframe, reevaluation is necessary to consider resistant pathogens or alternative diagnoses. 1

Common Pitfalls to Avoid

• Do not substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet, as they contain different ratios of clavulanic acid and are not equivalent. 2
• Do not use the 250 mg/125 mg tablets until the child weighs at least 40 kg due to different amoxicillin to clavulanic acid ratios. 2
• Ensure parents understand to avoid all other products containing amoxicillin or clavulanate to prevent overdosing. 4