What is the appropriate dosage of Amoxicillin (amoxicillin) for a 72.6 kilogram adult patient with potential impaired renal function?

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Amoxicillin 400mg/5ml Dosage for a 160-pound Adult

For a 72.6 kg (160 lb) adult with normal renal function, the standard amoxicillin dosage is 500 mg every 8 hours or 875 mg every 12 hours for most infections, which translates to approximately 12.5-15 mL of the 400mg/5mL suspension every 8-12 hours depending on infection severity. 1

Standard Adult Dosing

The FDA-approved dosing for adults weighing more than 40 kg is based on infection severity 1:

  • Mild to moderate infections (ear/nose/throat, skin, genitourinary): 500 mg every 12 hours OR 250 mg every 8 hours 1
  • Severe infections: 875 mg every 12 hours OR 500 mg every 8 hours 1
  • Lower respiratory tract infections (any severity): 875 mg every 12 hours OR 500 mg every 8 hours 1

Converting to 400mg/5mL Suspension

For the 400mg/5mL (80mg/mL) suspension formulation:

  • 500 mg dose = 6.25 mL of suspension
  • 875 mg dose = approximately 11 mL of suspension
  • 250 mg dose = 3.125 mL of suspension

Critical Considerations for Renal Impairment

If this patient has impaired renal function, dosing adjustments are mandatory to prevent drug accumulation 1, 2:

Severe Renal Impairment Dosing 1

  • GFR 10-30 mL/min: 500 mg or 250 mg every 12 hours (depending on infection severity)
  • GFR <10 mL/min: 500 mg or 250 mg every 24 hours
  • Hemodialysis patients: 500 mg or 250 mg every 24 hours, with an additional dose during and at the end of dialysis

Important caveat: Patients with GFR <30 mL/min should NOT receive the 875 mg dose 1. Regular monitoring of renal function is recommended during treatment in patients with severely impaired renal function 2.

Administration Guidelines

  • Take at the start of a meal to minimize gastrointestinal intolerance 1
  • Shake suspension well before each use 1
  • Store reconstituted suspension in refrigerator (preferred but not required); discard after 14 days 1
  • Continue treatment for minimum 48-72 hours beyond symptom resolution or bacterial eradication 1

Common Pitfalls to Avoid

  • Do not use 875 mg dosing in renal impairment (GFR <30 mL/min) as this can lead to excessive drug accumulation 1
  • Verify renal function before prescribing - the expanded question mentions "potential impaired renal function," which necessitates dose adjustment 2
  • Ensure adequate dosing intervals based on creatinine clearance to prevent toxicity 2
  • Amoxicillin is better absorbed than ampicillin, achieving 2-2.5 times higher blood levels, making it the preferred oral aminopenicillin 3

References

Guideline

Augmentin Dosing Considerations for Patients with Impaired Renal Function

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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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