What is the calculated pediatric dose of Amoxicillin-Clavulanate (Augmentin) for a 45kg child?

From the Guidelines

For a 45 kg boy, the recommended dose of amoxicillin-clavulanate would be 45-90 mg/kg/day of the amoxicillin component, divided into two doses, as per the guidelines from the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America 1. To calculate the dose, we can use the following formula: dose (mL) = (desired dose (mg/kg/day) x weight (kg)) / concentration (mg/mL). Using the 457 mg/5mL suspension, which contains 400 mg amoxicillin and 57 mg clavulanate per 5 mL, we can calculate the dose as follows:

• First, calculate the desired dose in mg: 45 mg/kg/day x 45 kg = 2025 mg/day for the lower end of the range, and 90 mg/kg/day x 45 kg = 4050 mg/day for the upper end of the range.
• Then, calculate the volume of suspension needed: for the lower end, 2025 mg / (400 mg/5mL) = 2025 / 80 = 25.31 mL/day, and for the upper end, 4050 mg / (400 mg/5mL) = 4050 / 80 = 50.63 mL/day.
• Since the dose should be divided into two doses, we get: for the lower end, 25.31 mL/day / 2 = 12.655 mL/dose, and for the upper end, 50.63 mL/day / 2 = 25.315 mL/dose.
• A practical dosing would be approximately 12-25 mL twice daily. For most infections, the middle-to-upper range is appropriate, so approximately 17-25 mL twice daily would be reasonable. This dosing provides adequate blood levels of amoxicillin to treat common pediatric infections while maintaining appropriate levels of the clavulanate component, which inhibits beta-lactamase enzymes that can destroy amoxicillin. The medication should be given with food to reduce gastrointestinal side effects, and the full course (typically 7-10 days) should be completed even if symptoms improve earlier. The suspension should be refrigerated after reconstitution and shaken well before each dose.

From the FDA Drug Label

Based on the amoxicillin component, amoxicillin and clavulanate potassium should be dosed as follows: Patients Aged 12 weeks (3 months) and Older: See dosing regimens provided in Table 1. Table 1: Dosing in Patients Aged 12 weeks (3 months) and Older INFECTION DOSING REGIMEN Every 12 hours 200 mg/5 mL or 400 mg/5 mL oral suspension a 125 mg/5 mL or 250 mg/5 mL oral suspension a Otitis media b, sinusitis, lower respiratory tract infections, and more severe infections 45 mg/kg/day every 12 hours 40 mg/kg/day every 8 hours Less severe infections 25 mg/kg/day every 12 hours 20 mg/kg/day every 8 hours

To calculate the dose for a 45 kg boy, we need to determine the type of infection and the dosing regimen.

• For more severe infections, the dose is 45 mg/kg/day every 12 hours.
• For less severe infections, the dose is 25 mg/kg/day every 12 hours. Given the concentration of amox clav 457 mg/ml, we can calculate the dose as follows:
• For more severe infections: 45 mg/kg/day * 45 kg = 2025 mg per day, divided every 12 hours is 2025 mg / 2 = 1012.5 mg per dose.
• For less severe infections: 25 mg/kg/day * 45 kg = 1125 mg per day, divided every 12 hours is 1125 mg / 2 = 562.5 mg per dose. To administer the dose, we can calculate the volume of the suspension needed:
• For more severe infections: 1012.5 mg / 457 mg/ml = 2.22 ml per dose.
• For less severe infections: 562.5 mg / 457 mg/ml = 1.23 ml per dose. 2

From the Research

Calculating PEDs Dose for Amox Clav 457 mg/ml

To calculate the dose of Amox Clav 457 mg/ml for a 45 kg boy, we need to consider the following factors:

• The dosage recommendations for Amox Clav
• The weight of the child

Dosage Recommendations

The studies provided do not give specific dosage recommendations for Amox Clav 457 mg/ml for a 45 kg boy 3, 4, 5, 6, 7. However, we can look at the general dosage recommendations for Amox Clav.

General Dosage Recommendations

The general dosage recommendations for Amox Clav vary depending on the infection being treated and the age and weight of the child. According to the studies, Amox Clav is often used as empiric therapy for many infections, and the dosage is typically based on the severity of the infection and the patient's weight 3, 5.

Calculating the Dose

To calculate the dose of Amox Clav 457 mg/ml for a 45 kg boy, we would typically need to know the recommended dosage per kilogram of body weight. However, this information is not provided in the studies.

Some key points to consider when calculating the dose:

• The dosage of Amox Clav should be based on the severity of the infection and the patient's weight
• The studies do not provide specific dosage recommendations for Amox Clav 457 mg/ml for a 45 kg boy
• The general dosage recommendations for Amox Clav vary depending on the infection being treated and the age and weight of the child

Important Considerations

Some important considerations when calculating the dose of Amox Clav include:

• The potential for side effects, such as gastrointestinal upset and allergic reactions
• The importance of completing the full course of treatment to ensure that the infection is fully cleared
• The need to monitor the patient's response to treatment and adjust the dose as needed

Key factors to consider:

• Patient's weight: 45 kg
• Dosage form: Amox Clav 457 mg/ml
• Infection being treated: not specified
• Age of the patient: not specified

In summary, while we can consider the general dosage recommendations for Amox Clav and the importance of calculating the dose based on the patient's weight, we cannot provide a specific dose calculation for a 45 kg boy without more information.