Amoxicillin-Clavulanate (Amoxiclav) Dosing for an 11-Year-Old Child Weighing 22kg
For this 22kg child, administer 5 mL of 250/62 suspension three times daily, providing approximately 250mg of amoxicillin per dose (total 750mg/day or 34mg/kg/day). 1
Standard Age-Based Dosing Regimen
For children aged 7-12 years, the American Academy of Pediatrics recommends 5 mL three times daily of 250/62 suspension, which is the appropriate formulation and volume for this age group. 1
This dosing provides approximately 34mg/kg/day of the amoxicillin component for a 22kg child, which falls within the standard dosing range for mild to moderate infections. 1
When to Consider High-Dose Therapy
If this child has specific risk factors, escalate to high-dose amoxicillin-clavulanate at 90 mg/kg/day (approximately 1980mg/day) divided into 2 doses. 2, 1
Risk factors requiring high-dose therapy include:
- Recent antibiotic use within the past 3 months 2
- Daycare attendance 1
- Incomplete Haemophilus influenzae type b vaccination (less than 3 injections) 1
- Geographic area with high pneumococcal resistance (>10% penicillin-resistant S. pneumoniae) 1
- Concurrent purulent acute otitis media 2
- Moderate to severe illness 1
For high-dose therapy in this 22kg child, use approximately 11 mL of the 600mg/5mL (ES-600) formulation twice daily, providing 1320mg per dose or 2640mg total daily (120mg/kg/day of amoxicillin component). 2, 1
Treatment Duration and Monitoring
Continue treatment for 10 days for most respiratory infections, including pneumonia. 2, 1
Clinical improvement should be evident within 48-72 hours; if no improvement occurs, reevaluate the diagnosis and consider switching antibiotics or investigating for complications. 2, 1
The Infectious Diseases Society of America recommends continuing therapy for a minimum of 48-72 hours beyond symptom resolution. 3
Critical Dosing Considerations
Always verify the suspension concentration (125/31 vs 250/62 vs 600/42.9) before calculating the volume to avoid potentially dangerous dosing errors. 1
The high-dose formulation provides a 14:1 ratio of amoxicillin to clavulanate, which maintains efficacy while reducing diarrhea compared to other ratios. 1, 4
Maximum single dose is 2 grams per dose regardless of weight. 1
Administration Instructions
Administer at the start of meals to minimize gastrointestinal intolerance. 3
Shake the suspension well before each use. 3
Refrigeration is preferable but not required; discard any unused portion after 14 days. 3
Common Pitfalls to Avoid
Do not use subtherapeutic doses, as they fail to achieve adequate tissue concentrations and promote antimicrobial resistance. 1
For severe infections or high pneumococcal resistance areas, using standard doses when high-dose therapy is indicated leads to treatment failure with resistant organisms. 1
Most common adverse effects include diarrhea, nausea, and vomiting, though the high-dose 14:1 formulation causes less diarrhea than other preparations. 2, 1