Amoxiclav Syrup Dosing for an 11-Year-Old Child Weighing 22kg
For an 11-year-old child weighing 22kg, the recommended dose is 5 ml of amoxiclav 250/62 suspension three times daily, providing approximately 250mg of amoxicillin per dose. 1, 2
Age-Based Dosing Algorithm
The dosing of amoxiclav syrup follows an age-based algorithm rather than strict weight-based calculations for standard infections 1, 2:
- Children 7-12 years: 5 ml of 250/62 suspension three times daily 1, 2, 3
- This provides approximately 250mg amoxicillin and 62mg clavulanic acid per dose 1
- Total daily dose: approximately 750mg amoxicillin (34 mg/kg/day for this 22kg child) 1
Critical Dosing Considerations
Verify the suspension concentration before dispensing - the 125/31 suspension used for younger children (1-6 years) would result in significant underdosing if given to this 11-year-old child 2, 3. The 250/62 formulation is specifically indicated for children over 6 years of age 1, 2.
When Higher Doses Are Indicated
For severe infections or when resistant organisms are suspected (particularly penicillin-resistant Streptococcus pneumoniae), consider high-dose therapy 3, 4:
- High-dose regimen: 90 mg/kg/day of amoxicillin component in 2 divided doses 3, 5
- For a 22kg child: approximately 1000mg amoxicillin twice daily 3
- This requires the high-dose 14:1 ratio formulation (600mg/5ml suspension) 3, 4, 5
Risk factors requiring high-dose therapy include 3:
- Age <2 years (not applicable here)
- Recent antibiotic use within 30 days 3, 6
- Daycare attendance 3
- Incomplete Haemophilus influenzae type b vaccination 3
- Moderate to severe illness 3
- Geographic areas with >10% penicillin-resistant S. pneumoniae 3, 6
Intravenous Dosing for Severe Infections
If the child requires hospitalization or has severe infection, the IV dose is 30 mg/kg three times daily, which equals 660mg IV every 8 hours for this 22kg child 1, 6.
Duration of Therapy
- Standard respiratory infections: 7-10 days 6
- Bacterial pneumonia: 10 days 3
- Acute bacterial rhinosinusitis: 10-14 days 3
Common Pitfalls to Avoid
Do not use the 125/31 suspension for children over 6 years - this is the most common dosing error and results in delivering only half the intended amoxicillin dose 2, 3. Always confirm you are dispensing the 250/62 formulation for this age group 1, 2.
Assess clinical response within 48-72 hours - if no improvement or worsening occurs, reevaluate the diagnosis and consider switching antibiotics or investigating for complications 3, 6.