What is the appropriate dose of Augmentin (amoxicillin-clavulanate) for a 7-year-old female patient weighing 24.23 kg?

Augmentin Dosing for 24.23 kg, 7-Year-Old Female

For a 7-year-old female weighing 24.23 kg, the recommended Augmentin dose is 45 mg/kg/day divided every 12 hours for mild-to-moderate infections (approximately 545 mg twice daily of the amoxicillin component), or 90 mg/kg/day divided every 12 hours for severe infections or areas with high pneumococcal resistance (approximately 1090 mg twice daily of the amoxicillin component). 1, 2

Standard Dosing Regimen (Mild-to-Moderate Infections)

• 45 mg/kg/day divided every 12 hours is the preferred regimen for most respiratory tract infections, otitis media, sinusitis, and lower respiratory tract infections 1, 2
• For this 24.23 kg child: 45 mg/kg/day = 1090 mg total daily dose, given as 545 mg twice daily of the amoxicillin component 1
• This can be administered using the 400 mg/57 mg per 5 mL suspension: approximately 6.8 mL twice daily 2
• Alternatively, using the 250 mg/62.5 mg per 5 mL suspension: approximately 10.9 mL twice daily 2

High-Dose Regimen (Severe Infections or High Resistance Areas)

• 90 mg/kg/day divided every 12 hours is indicated for severe respiratory infections, community-acquired pneumonia in areas with high pneumococcal resistance, or recent antibiotic exposure within 3 months 1, 2
• For this 24.23 kg child: 90 mg/kg/day = 2180 mg total daily dose, given as 1090 mg twice daily of the amoxicillin component 1
• This can be administered using the 400 mg/57 mg per 5 mL suspension: approximately 13.6 mL twice daily 2
• The maximum daily dose should not exceed 4000 mg/day of the amoxicillin component 1, 2

Key Clinical Considerations

Dosing Interval

• Every 12-hour dosing is strongly preferred over every 8-hour dosing because it is associated with significantly less diarrhea and improved adherence 2, 3
• The every 12-hour regimen maintains therapeutic concentrations while reducing gastrointestinal adverse effects 2

Formulation Selection

• Do NOT substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet, as they contain different amounts of clavulanic acid and are not equivalent 2
• The 250 mg/125 mg tablets should not be used until the child weighs at least 40 kg 2
• For this weight range, liquid suspension formulations are most appropriate 2

Duration of Therapy

• 7-10 days for most respiratory infections, with pneumonia specifically requiring 10 days of treatment 1
• For acute otitis media, the recommended duration is 10 days 2

Monitoring and Follow-Up

• Children on appropriate antibiotic therapy should show clinical improvement within 48-72 hours 1
• If no improvement occurs within this timeframe, reevaluation is necessary to consider resistant organisms or alternative diagnoses 1
• Complete the full course even if symptoms improve before completion 1

Administration Tips

• Augmentin may be given with or without food, though administration with meals may improve gastrointestinal tolerability 1
• Use an appropriate measuring device (oral syringe) for accurate liquid dosing 1

Common Pitfalls to Avoid

• Avoid underdosing in areas with high pneumococcal resistance: If there is local resistance or recent antibiotic exposure, the high-dose regimen (90 mg/kg/day) should be used 1
• Do not use every 8-hour dosing unless specifically indicated: The every 12-hour regimen has better tolerability and equivalent efficacy 2, 3
• Ensure proper formulation selection: Using adult tablet formulations in children under 40 kg can lead to incorrect clavulanate dosing 2