Augmentin Dosing for a 7-Year-Old Weighing 29 kg
For a 7-year-old child weighing 29 kg, the recommended dose of Augmentin depends on infection severity: for standard infections, give 5 mL of 250/62.5 mg suspension three times daily (approximately 750 mg amoxicillin/day), or for high-risk infections requiring enhanced coverage against resistant organisms, use the high-dose regimen of 90 mg/kg/day (2,610 mg amoxicillin/day) divided into two doses. 1, 2
Standard Dosing Regimen
For children aged 7-12 years with less severe infections:
- Give 5 mL of 250/62.5 mg suspension three times daily 1, 2
- This provides approximately 250 mg amoxicillin per dose, totaling 750 mg/day 1
- This corresponds to roughly 25-26 mg/kg/day for a 29 kg child 2
- Treatment duration is typically 7-10 days for most respiratory infections 2
High-Dose Regimen Indications
Use the high-dose regimen (90 mg/kg/day divided into 2 doses) if any of these risk factors are present: 1, 3
- Age under 2 years 1
- Daycare attendance 1, 3
- Recent antibiotic use within the previous 30 days 1, 3
- Geographic area with high prevalence (>10%) of penicillin-resistant Streptococcus pneumoniae 1, 3
- Moderate to severe illness 1
- Incomplete Haemophilus influenzae type b vaccination 1
- Concurrent purulent otitis media 1
- Treatment failure with standard-dose amoxicillin 1
High-Dose Calculation for 29 kg Child
- 90 mg/kg/day = 2,610 mg amoxicillin per day 1
- Divided into 2 doses = 1,305 mg per dose (approximately 1,300 mg twice daily) 1
- This requires the high-dose formulation with 14:1 ratio (90 mg/6.4 mg per kg per day) 1
Critical Dosing Considerations
Verify the suspension concentration before dispensing to avoid dosing errors, as the 125/31 mg formulation differs significantly from the 250/62.5 mg formulation 1
Do not substitute formulations: Two 250/125 mg tablets are not equivalent to one 500/125 mg tablet due to different clavulanate ratios 4
The high-dose formulation (14:1 ratio) causes less diarrhea than standard formulations while maintaining superior efficacy against resistant organisms 1
Clinical Response Monitoring
- Evaluate clinical response within 48-72 hours of initiating therapy 2, 3
- If no improvement or worsening occurs after 72 hours, consider switching antibiotics or reevaluating the diagnosis 5, 3
- High-dose amoxicillin-clavulanate demonstrates 90-92% predicted clinical efficacy against resistant pathogens 5, 3
Common Pitfalls to Avoid
Underdosing leads to treatment failure with resistant organisms and promotes antimicrobial resistance 1
Using standard doses when high-dose therapy is indicated results in inadequate serum and tissue concentrations to overcome resistant S. pneumoniae 1
Most upper respiratory tract infections are viral and do not require antibiotics at all—ensure the child meets criteria for bacterial infection before prescribing 1