What is the recommended dose of Amoxil (amoxicillin) for an 8-year-old male weighing 60 pounds with normal renal function and no known allergies to penicillin or other beta-lactam antibiotics?

Amoxicillin Dosing for an 8-Year-Old Weighing 60 Pounds

For an 8-year-old child weighing 60 pounds (27.3 kg), the recommended dose of amoxicillin is 45 mg/kg/day divided into two doses (approximately 615 mg twice daily) for mild to moderate infections, or 90 mg/kg/day divided into two doses (approximately 1,230 mg twice daily) for severe infections or areas with high pneumococcal resistance. 1

Weight-Based Calculation

• The child weighs 60 pounds, which converts to approximately 27.3 kg 1
• This weight falls into the pediatric dosing category for children ≥3 months and <40 kg 2

Standard Dosing Algorithm by Infection Severity

Mild to Moderate Infections

• Dose: 45 mg/kg/day divided every 12 hours 1
• For this 27.3 kg child: 27.3 kg × 45 mg/kg/day = 1,229 mg/day total
• Practical dosing: 615 mg twice daily (approximately 12 mL of 250 mg/5 mL suspension twice daily) 1
• This regimen is appropriate for uncomplicated respiratory tract infections, skin infections, and genitourinary infections 1

Severe Infections or High-Resistance Areas

• Dose: 90 mg/kg/day divided every 12 hours 1
• For this 27.3 kg child: 27.3 kg × 90 mg/kg/day = 2,457 mg/day total
• Practical dosing: 1,230 mg twice daily (approximately 24 mL of 250 mg/5 mL suspension twice daily) 1
• This higher dose is indicated for community-acquired pneumonia in areas with >10% penicillin-resistant S. pneumoniae, children <2 years old, recent antibiotic exposure within 30 days, daycare attendance, or severe infections requiring hospitalization 1

Indication-Specific Dosing Considerations

Community-Acquired Pneumonia

• Mild to moderate outpatient cases: 45 mg/kg/day divided every 12 hours 1
• Severe cases or high-resistance areas: 90 mg/kg/day divided every 12 hours 1
• Treatment duration: 10 days 1

Group A Streptococcal Pharyngitis

• Dose: 50-75 mg/kg/day divided into 2 doses for 10 days 1
• For this 27.3 kg child: 1,365-2,048 mg/day total
• Maximum per dose: 1,000 mg 1
• Must complete full 10-day course to prevent acute rheumatic fever 2

Acute Bacterial Sinusitis

• Children ≥2 years without risk factors: 45 mg/kg/day divided every 12 hours 1
• Children <2 years, in daycare, or with recent antibiotic use: 80-90 mg/kg/day divided every 12 hours 1

Critical Safety Parameters

• Maximum daily dose: 4,000 mg/day regardless of weight 1
• For this 27.3 kg child, even the high-dose regimen (2,457 mg/day) remains well below the maximum 1
• Treatment should continue for minimum 48-72 hours beyond symptom resolution 2

Administration Instructions

• Take at the start of a meal to minimize gastrointestinal intolerance 2
• Shake oral suspension well before each use 2
• Refrigeration is preferable but not required 2
• Discard any unused suspension after 14 days 2

When to Consider Amoxicillin-Clavulanate Instead

• If β-lactamase-producing organisms (H. influenzae, M. catarrhalis) are suspected, switch to amoxicillin-clavulanate at 90 mg/kg/day of the amoxicillin component 1
• This is particularly relevant for children with recent antibiotic exposure within 4-6 weeks 1

Monitoring and Follow-Up

• Children on appropriate therapy should demonstrate clinical improvement within 48-72 hours 1
• If no improvement occurs within this timeframe, reevaluation and further investigation are necessary 1
• Complete the full prescribed course even if symptoms improve before completion 1