Augmentin Dosing for a 10-Year-Old Child
For a 10-year-old child, the appropriate Augmentin dosage depends on the child's weight and the severity of infection: if the child weighs ≥40 kg, use adult dosing of 500 mg every 12 hours for mild/moderate infections or 875 mg every 12 hours for severe infections; if <40 kg, use 25 mg/kg/day divided every 12 hours for mild/moderate infections or 45 mg/kg/day divided every 12 hours for severe infections (based on the amoxicillin component). 1
Weight-Based Dosing Algorithm
For Children Weighing ≥40 kg (88 lbs)
- Mild to moderate infections (ear/nose/throat, skin, genitourinary): 500 mg every 12 hours 1
- Severe infections or lower respiratory tract infections: 875 mg every 12 hours 1
For Children Weighing <40 kg
- Mild to moderate infections: 25 mg/kg/day of amoxicillin component divided every 12 hours 1
- Severe infections or lower respiratory tract infections: 45 mg/kg/day of amoxicillin component divided every 12 hours 1
High-Dose Regimen for Resistant Pathogens
For community-acquired pneumonia or infections with suspected penicillin-resistant Streptococcus pneumoniae or β-lactamase-producing organisms, use 90 mg/kg/day of the amoxicillin component divided into 2 doses, with a maximum of 4000 mg per day. 2
- This high-dose regimen (90 mg/kg/day) provides optimal coverage against penicillin-resistant S. pneumoniae and β-lactamase-producing Haemophilus influenzae 2, 3
- The American Academy of Pediatrics specifically recommends this dosing for children with recent antibiotic exposure (within 3 months) or in areas with high pneumococcal resistance 2
Treatment Duration
- Minimum duration: Continue treatment for 48-72 hours beyond symptom resolution 1
- Streptococcal infections: Minimum 10 days to prevent acute rheumatic fever 1
- Pneumonia: 10 days of treatment is standard 2
- Most respiratory infections: 7-10 days 2
Clinical Monitoring
- Expected improvement: Children should show clinical improvement within 48-72 hours of starting appropriate therapy 2
- If no improvement: Reevaluate and consider alternative pathogens or treatment failure 2
Important Considerations
Administration
- Give at the start of meals to minimize gastrointestinal intolerance 1
- Shake oral suspension well before each use 1
- Refrigeration is preferable but not required; discard unused suspension after 14 days 1
Common Pitfalls to Avoid
- Do not use the 875 mg tablet in children with renal impairment (GFR <30 mL/min) 1
- Do not underdose in areas with high pneumococcal resistance—use the 90 mg/kg/day regimen when indicated 2, 3
- Do not confuse the amoxicillin component dose with the total Augmentin dose when calculating pediatric dosing 2
Tolerability
The high-dose formulation (90/6.4 mg/kg/day) shows similar tolerability to conventional formulations, with diarrhea being the most common adverse effect, which is generally less frequent with twice-daily dosing 4, 5