What is the dose of Sugmentin (amoxicillin and clavulanic acid) in teaspoons for a 30kg pediatric patient, given a concentration of 457mg/5ml?

Augmentin 457mg/5ml Dosing for a 30kg Child

For a 30kg child requiring high-dose Augmentin therapy, administer 7.5ml of the 457mg/5ml suspension twice daily (every 12 hours). 1

Dose Calculation

• The recommended high-dose regimen for pediatric respiratory infections is 90 mg/kg/day of the amoxicillin component divided into 2 doses 1, 2
• For a 30kg child: 30kg × 90 mg/kg/day = 2,700 mg/day total, or 1,350 mg per dose 1
• Using the 457mg/5ml concentration: 1,350 mg ÷ 457 mg = approximately 2.95, which rounds to 3 units of 5ml = 15ml per dose for the high-dose regimen 1
• However, if using standard dosing (45 mg/kg/day in 2 doses): 30kg × 45 mg/kg/day = 1,350 mg/day total, or 675 mg per dose = 7.5ml twice daily 1, 2

When to Use High-Dose vs Standard Dosing

High-dose therapy (15ml twice daily) is indicated if the child has: 1

• Age <2 years
• Daycare attendance
• Recent antibiotic use within past 30 days
• Incomplete Haemophilus influenzae type b vaccination
• Geographic area with >10% penicillin-resistant Streptococcus pneumoniae
• Moderate to severe illness
• Concurrent purulent acute otitis media

Standard dosing (7.5ml twice daily) is appropriate for: 1, 2

• Children without the above risk factors
• Mild to moderate infections
• Fully immunized children in low-resistance areas

Treatment Duration and Monitoring

• Continue therapy for 10 days for most respiratory tract infections 1, 3
• Clinical improvement should be evident within 48-72 hours; if no improvement occurs, reevaluation is necessary 1, 2
• Fever typically resolves within 24-48 hours for pneumococcal infections, though cough may persist longer 3

Critical Dosing Considerations

• The 457mg/5ml formulation provides a 14:1 ratio of amoxicillin to clavulanate, which causes less diarrhea than other preparations while maintaining efficacy 1
• Always verify the suspension concentration before calculating volume to avoid dosing errors 1
• Administer at the start of meals to minimize gastrointestinal side effects 4
• The maximum daily dose should not exceed 4,000 mg of amoxicillin regardless of weight 1, 3

Common Pitfall to Avoid

• Do not underdose: Using standard doses when high-dose therapy is indicated leads to treatment failure with resistant organisms 1
• Subtherapeutic doses fail to achieve adequate tissue concentrations and promote antimicrobial resistance 1