Amoxicillin-Clavulanate Dosing for an 11-Year-Old Weighing 22kg
For an 11-year-old child weighing 22kg, administer 5 ml of 250/62 suspension three times daily, which provides approximately 250mg of amoxicillin per dose (total 750mg daily or 34mg/kg/day). 1
Standard Age-Based Dosing
Children aged 7-12 years should receive 5 ml of 250/62 suspension three times daily, regardless of the specific indication, as this is the standard age-appropriate formulation. 2, 1
This dosing provides approximately 34mg/kg/day of amoxicillin for a 22kg child, which is appropriate for most common pediatric infections including upper respiratory tract infections, uncomplicated pneumonia, and skin infections. 1
When High-Dose Therapy Is Required
If this child has risk factors for resistant organisms or specific severe infections, escalate to high-dose therapy: 90mg/kg/day (approximately 1980mg daily) divided into 2 doses. 2
Risk factors requiring high-dose therapy include:
- Age <2 years (not applicable here)
- Daycare attendance 2
- Recent antibiotic use within the past 3 months 2
- Incomplete Haemophilus influenzae type b vaccination 2
- Geographic area with high pneumococcal resistance (>10% penicillin-resistant S. pneumoniae) 2
- Moderate to severe illness 2
- Concurrent purulent acute otitis media 2
Specific Clinical Indications
For acute bacterial rhinosinusitis, acute otitis media, or community-acquired pneumonia in this age group with risk factors, the high-dose regimen (90mg/kg/day in 2 divided doses) is strongly recommended as first-line therapy. 2
For presumed bacterial pneumonia requiring outpatient treatment, use 90mg/kg/day of the amoxicillin component in 2 doses (maximum 4000mg/day). 2
Treatment Duration and Monitoring
Continue treatment for 10 days for most respiratory tract infections including bacterial pneumonia, acute otitis media, and acute bacterial rhinosinusitis. 2
Clinical improvement should occur within 48-72 hours; if no improvement or worsening occurs after 72 hours, reassess the diagnosis, consider atypical pathogens, and evaluate for complications or treatment failure with resistant organisms. 2
Administration and Tolerability
The medication can be administered with or without food, though giving it with meals may improve gastrointestinal tolerability. 1
Common adverse effects include diarrhea, nausea, vomiting, and rash, but the difference in adverse effects between standard and high-dose regimens is generally negligible. 2
The 14:1 ratio formulation (90/6.4 mg/kg/day) causes less diarrhea than other amoxicillin-clavulanate preparations while maintaining efficacy. 2
Critical Pitfall to Avoid
Always verify the suspension concentration (125/31 vs 250/62) before calculating the volume to avoid dosing errors. 2 Using the wrong concentration is a common mistake that leads to either underdosing (treatment failure and resistance) or overdosing (increased adverse effects).