PediaMox (Amoxicillin) Dosing Frequency
PediaMox (amoxicillin) is administered twice daily for most pediatric respiratory infections, including community-acquired pneumonia, when using the high-dose regimen of 90 mg/kg/day. 1, 2, 3
Standard Dosing Regimens
High-Dose Regimen (Preferred for Respiratory Infections)
- 90 mg/kg/day divided into 2 doses (every 12 hours) is the recommended regimen for community-acquired pneumonia and severe respiratory infections in children over 3 months 1, 2, 3
- This twice-daily dosing provides optimal coverage against penicillin-resistant Streptococcus pneumoniae and maintains therapeutic concentrations throughout the day 1, 2
- The maximum daily dose is 4 grams per day 1, 2
Standard-Dose Regimen (Mild to Moderate Infections)
- 45 mg/kg/day can be given either twice daily (every 12 hours) OR three times daily (every 8 hours) for mild to moderate infections 4
- The FDA label specifically states: "25 mg/kg/day in divided doses every 12 hours OR 20 mg/kg/day in divided doses every 8 hours" for mild/moderate infections 4
Clinical Context for Dosing Frequency
When to Use Twice-Daily Dosing
- Community-acquired pneumonia requiring high-dose therapy (90 mg/kg/day) - always given twice daily 1, 2, 3
- Areas with high pneumococcal resistance - twice-daily high-dose regimen preferred 1, 2
- Improved adherence - twice-daily dosing has better compliance compared to three-times-daily regimens 2
When Three-Times-Daily Dosing May Be Used
- Mild to moderate infections with standard dosing (45 mg/kg/day) - can be divided into three doses 4
- Specific pathogens like β-lactamase producing H. influenzae when using amoxicillin-clavulanate at 45 mg/kg/day 2
Important Clinical Considerations
- Treatment duration is typically 10 days for pneumonia, regardless of whether dosing is twice or three times daily 1, 2, 3
- Clinical improvement should occur within 48-72 hours; if not, reevaluation is necessary 1, 2, 3
- The twice-daily high-dose regimen (90 mg/kg/day) is specifically designed for pneumonia and should not be given three times daily 1, 2
- Administer at the start of meals to minimize gastrointestinal intolerance 4