What is the recommended dose of Amoxiclav (amoxicillin/clavulanic acid) syrup in mL for a 1-year-old child weighing 9.58 kg?

Amoxiclav Dosing for a 1-Year-Old Weighing 9.58 kg

For a 1-year-old child weighing 9.58 kg, the recommended dose of Amoxiclav (amoxicillin/clavulanic acid) syrup is 2.5 mL of the 125/31 mg per 5 mL suspension given three times daily, or 4.3 mL of the same suspension given twice daily if using the high-dose regimen.

Standard Dosing Algorithm

The dosing of Amoxiclav in pediatric patients depends on the severity of infection and local resistance patterns:

For Mild to Moderate Infections

• Standard dose: 45 mg/kg/day of the amoxicillin component divided into 2 doses 1, 2
• For a 9.58 kg child: 45 mg/kg/day × 9.58 kg = 431 mg/day total
• This equals approximately 215 mg per dose twice daily
• Using 125 mg/5 mL suspension: 8.6 mL twice daily (or 4.3 mL if using the 250 mg/5 mL formulation)
• Alternatively, the 125/31 suspension can be given as 2.5 mL three times daily (approximately 25 mg/kg/day in 3 divided doses) 1

For Severe Infections or High Pneumococcal Resistance Areas

• High-dose regimen: 90 mg/kg/day of the amoxicillin component divided into 2 doses 2, 3
• For a 9.58 kg child: 90 mg/kg/day × 9.58 kg = 862 mg/day total
• This equals approximately 431 mg per dose twice daily
• Using 250 mg/5 mL suspension: 8.6 mL twice daily

Indication-Specific Considerations

When to use high-dose regimen 2, 3:

• Community-acquired pneumonia in areas with >10% penicillin-resistant S. pneumoniae
• Children <2 years old with respiratory infections
• Recent antibiotic exposure within the past 30 days
• Daycare attendance
• Severe infections requiring hospitalization
• Recurrent or persistent infections after amoxicillin failure

When standard dose is appropriate 1, 2:

• Mild to moderate respiratory tract infections
• Skin and soft tissue infections
• Uncomplicated urinary tract infections
• No recent antibiotic exposure

Practical Administration Guidelines

Formulation selection 4:

• The 125 mg/5 mL suspension is most appropriate for this weight range
• Administer at the start of meals to minimize gastrointestinal intolerance 4
• Shake suspension well before each use 4
• Refrigeration is preferable but not required; discard unused portion after 14 days 4

Treatment Duration and Monitoring

Standard treatment course 1:

• Most respiratory infections: 7-10 days
• Pneumonia specifically: 10 days
• Continue for minimum 48-72 hours beyond symptom resolution 4

Expected clinical response 1, 2:

• Children on adequate therapy should demonstrate clinical improvement within 48-72 hours 1
• If no improvement occurs within this timeframe, reevaluation and further investigation are necessary 1, 2
• Fever typically resolves within 24-48 hours for pneumococcal infections 2

Critical Dosing Considerations

Important caveats 1, 2, 3:

• The high-dose formulation (90 mg/kg/day) provides optimal coverage for penicillin-resistant Streptococcus pneumoniae and β-lactamase-producing organisms 2, 3
• Twice-daily dosing is associated with less diarrhea compared to three-times-daily administration 3
• The addition of clavulanate is essential for β-lactamase-producing organisms (H. influenzae, M. catarrhalis) with eradication rates approaching 100% 2, 3
• Maximum daily dose should not exceed 4000 mg of amoxicillin component regardless of weight 2

Common Pitfalls to Avoid

• Underdosing in severe infections: Using standard dose when high-dose is indicated can lead to treatment failure, particularly with resistant organisms 2, 3
• Incorrect suspension concentration: Always verify whether using 125 mg/5 mL or 250 mg/5 mL formulation before calculating volume 4
• Premature discontinuation: Complete the full course even if symptoms improve before completion 2
• Ignoring risk factors: Children with recent antibiotic exposure, daycare attendance, or age <2 years should receive high-dose regimen for respiratory infections 2