What is the recommended dose of Augmentin (amoxicillin/clavulanic acid) suspension for a 1-year-old patient?

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Augmentin Suspension Dosing for a 1-Year-Old

For a 1-year-old child, the American Academy of Pediatrics recommends 5 mL of 125/31 suspension three times daily for standard infections, or high-dose therapy at 90 mg/kg/day of the amoxicillin component divided into 2 doses for severe infections or when resistant organisms are suspected. 1

Standard Dosing Regimen

  • For children aged 1-6 years, the recommended dose is 5 mL of 125/31 suspension three times daily, providing approximately 125 mg of amoxicillin per dose (375 mg total daily). 1

  • This standard regimen is appropriate for most common pediatric infections including uncomplicated respiratory tract infections and soft tissue infections. 1

High-Dose Regimen Indications

High-dose amoxicillin-clavulanate (90 mg/kg/day of amoxicillin with 6.4 mg/kg/day of clavulanate in 2 divided doses) is strongly indicated for 1-year-old children with specific risk factors: 1

  • Age under 2 years (which applies to all 1-year-olds) 1
  • Daycare attendance 1
  • Recent antibiotic use within the previous 30 days 1
  • Incomplete Haemophilus influenzae type b vaccination (less than 3 injections) 1
  • Geographic area with high prevalence of penicillin-resistant Streptococcus pneumoniae (>10%) 1
  • Moderate to severe illness 1

Weight-Based Calculation for High-Dose Therapy

  • For a typical 1-year-old weighing approximately 10 kg, the high-dose regimen would be 900 mg of amoxicillin per day (90 mg/kg × 10 kg), divided into 2 doses of 450 mg each. 1

  • The high-dose formulation provides a 14:1 ratio of amoxicillin to clavulanate, which causes less diarrhea than other preparations while maintaining efficacy against resistant organisms. 1, 2

Treatment Duration

  • The standard treatment duration is 10 days for most pediatric respiratory infections, including acute otitis media, pneumonia, and acute bacterial rhinosinusitis. 1, 3

  • Clinical improvement should be evident within 48-72 hours; if no improvement or worsening occurs after 72 hours, reevaluation and consideration of switching antibiotics or further investigation is necessary. 1, 3

Critical Dosing Considerations

  • Always verify the suspension concentration (125/31 vs 250/62) before calculating volume to avoid dosing errors. 1

  • The high-dose regimen achieves middle ear fluid concentrations adequate to overcome penicillin-resistant S. pneumoniae with predicted clinical efficacy of 90-92%. 1, 2

  • Using standard doses when high-dose therapy is indicated leads to treatment failure with resistant organisms. 1

Common Pitfalls to Avoid

  • Underdosing is a critical error—subtherapeutic doses fail to achieve adequate serum and tissue concentrations and promote antimicrobial resistance. 1

  • Most upper respiratory tract infections are viral and do not require antibiotics at all; ensure bacterial infection criteria are met before prescribing. 1

  • The twice-daily high-dose regimen (90/6.4 mg/kg/day) has better compliance and similar or lower rates of diarrhea compared to three-times-daily standard dosing. 1, 4

Adverse Effects

  • The most common adverse effects include diarrhea, nausea, vomiting, and rash, which are generally mild and transient. 1, 3

  • Diarrhea occurs in approximately 7-11% of patients, with lower rates observed in twice-daily versus three-times-daily dosing regimens. 4

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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