What is the recommended dose of Augmentin (amoxicillin/clavulanate) for a 13-year-old pediatric patient weighing 88 pounds?

Augmentin Dosing for a 13-Year-Old Weighing 88 Pounds

For a 13-year-old patient weighing 88 pounds (40 kg), the standard Augmentin dose is 25 mg/kg/day divided into two or three doses, which equals approximately 1000 mg per day (500 mg twice daily or 333 mg three times daily) for most common infections. 1

Weight-Based Dosing Calculation

• Patient weight: 88 pounds = 40 kg exactly
• Standard pediatric dosing for Augmentin is 25 mg/kg/day for mild to moderate infections 1
• For this patient: 25 mg/kg × 40 kg = 1000 mg total daily dose
• This can be administered as:
  • 500 mg twice daily (most common regimen) 1
  • 333 mg three times daily (alternative regimen) 1

High-Dose Considerations for Resistant Infections

For recurrent or persistent infections (particularly acute otitis media) or when drug-resistant Streptococcus pneumoniae is suspected, high-dose Augmentin at 90 mg/kg/day of the amoxicillin component is recommended. 2, 3

• High-dose calculation: 90 mg/kg × 40 kg = 3600 mg amoxicillin per day
• This is typically given as 1800 mg twice daily using the high-dose formulation (Augmentin ES-600 or equivalent) 2, 3
• The high-dose formulation maintains the same clavulanate dose while doubling the amoxicillin component 3

Clinical Decision Algorithm

Use standard dosing (25 mg/kg/day) for:

• First-line treatment of uncomplicated respiratory infections 2
• Skin and soft tissue infections 2
• Urinary tract infections 2

Use high-dose formulation (90 mg/kg/day) for:

• Recurrent or persistent acute otitis media 3
• Recent antibiotic exposure within the past 30 days 3
• Daycare attendance or known exposure to resistant organisms 3
• Failed initial therapy with standard-dose amoxicillin 3

Administration Considerations

• Administer with food to minimize gastrointestinal side effects 1
• Peak plasma concentrations occur 60-90 minutes after oral administration 1
• The syrup formulation is well-tolerated in this age group, though tablets are also appropriate for a 13-year-old 1

Common Pitfalls to Avoid

• Do not use adult fixed dosing (such as 875 mg twice daily) without confirming it matches the appropriate mg/kg calculation for this patient's weight 4
• Do not confuse the 4:1,7:1, and 14:1 amoxicillin-to-clavulanate ratios when prescribing high-dose formulations 3
• Ensure adequate hydration as the terminal half-life is approximately 1.4 hours for amoxicillin and 1.0 hours for clavulanic acid, requiring consistent dosing intervals 1
• Monitor for diarrhea, which is more common with higher clavulanate doses; the high-dose formulation minimizes this by maintaining lower clavulanate while increasing amoxicillin 3