Co-Amoxiclav Dosing for a 22kg, 7-Year-Old Child
For a 22kg, 7-year-old child, give 5 mL of the 457mg/5mL (250/62) suspension three times daily, providing approximately 250mg of amoxicillin per dose. 1
Age-Based Dosing Algorithm
The American Academy of Pediatrics recommends age-based dosing for co-amoxiclav in children, rather than strict weight-based calculations for standard infections 1:
- Children 7-12 years: 5 mL of 250/62 suspension three times daily 1
- This provides approximately 750mg total daily amoxicillin (34mg/kg/day for this 22kg child) 1
When High-Dose Regimen Is Required
If treating infections requiring high-dose therapy (90mg/kg/day), this child would need approximately 10 mL of the 457mg/5mL suspension twice daily (providing ~1980mg amoxicillin/day) 1. High-dose regimens are indicated for 1:
- Age <2 years
- Daycare attendance
- Recent antibiotic use (within 4-6 weeks)
- Incomplete Haemophilus influenzae type b vaccination
- Geographic areas with high pneumococcal resistance (>10%)
- Moderate to severe illness
- Concurrent purulent otitis media
Critical Dosing Considerations
Always verify the suspension concentration before calculating volume 1. The 457mg/5mL formulation is equivalent to 250/62 (250mg amoxicillin/62mg clavulanate per 5mL) and is specifically indicated for children over 6 years 1.
For severe infections requiring IV therapy, the dose would be 30mg/kg three times daily IV, which equals 660mg IV every 8 hours for this 22kg child 1.
Treatment Duration and Monitoring
- Standard duration: 7-10 days for most respiratory infections 1, 2
- Pneumonia: 10 days specifically 1, 2
- Expected improvement: Clinical improvement should occur within 48-72 hours; if not, reevaluation is necessary 1, 2
Common Pitfall to Avoid
The most common error is confusing suspension concentrations (125/31 vs 250/62 vs 457mg/5mL formulations), which can lead to significant underdosing or overdosing 1. The 457mg/5mL suspension you have is the higher concentration formulation appropriate for this age group 1.