Augmentin Dosing for an 8-Year-Old Weighing 93 Pounds
For an 8-year-old patient weighing 93 pounds (42.2 kg) with normal renal function and a mild to moderate infection, administer Augmentin at 45 mg/kg/day of the amoxicillin component divided into two doses, which equals approximately 950 mg twice daily (1,900 mg total daily dose). 1
Weight-Based Calculation
- The patient weighs 93 pounds, which converts to 42.2 kg 1
- Using the standard dosing regimen of 45 mg/kg/day: 42.2 kg × 45 mg/kg = 1,899 mg/day total amoxicillin component 1, 2
- This divides into approximately 950 mg twice daily (every 12 hours) 1
Severity-Based Dosing Algorithm
- For mild to moderate infections (most respiratory tract infections, uncomplicated UTIs, skin infections): Use the standard dose of 45 mg/kg/day divided into two doses 1, 2
- For severe infections or high-risk situations (geographic areas with >10% penicillin-resistant S. pneumoniae, recent antibiotic exposure within 4-6 weeks, daycare attendance, treatment failure): Use the high-dose regimen of 90 mg/kg/day divided into two doses, which would be 42.2 kg × 90 mg/kg = 3,798 mg/day, or approximately 1,900 mg twice daily 1, 2
Maximum Dose Considerations
- The maximum single dose should not exceed 2,000 mg regardless of weight 1
- For this patient at 42.2 kg, the standard dose of 950 mg twice daily is well below the maximum threshold 1
Formulation Selection
- Use the high-dose formulation with a 14:1 ratio of amoxicillin to clavulanate to minimize gastrointestinal side effects while maintaining efficacy 1
- This formulation is preferred over standard formulations for pediatric patients requiring weight-based dosing 1
Treatment Duration
- Continue treatment for 10 days for most respiratory infections, including pneumonia and acute bacterial sinusitis 1
- For uncomplicated UTIs, treatment duration of 3-7 days is appropriate 3
- For complicated UTIs, extend treatment to 7-14 days 3
Monitoring Parameters
- Clinical improvement should be evident within 48-72 hours of initiating treatment 1, 3
- If no improvement or worsening occurs, reevaluation is necessary and consider switching to the high-dose regimen or alternative antibiotics 1
Critical Pitfalls to Avoid
- Underdosing is the most critical error: Using standard doses when high-dose therapy is indicated leads to treatment failure with resistant organisms 1, 2
- Do not use adult dosing for pediatric patients under 40 kg: Always calculate based on weight in mg/kg 2
- Verify the indication: Most upper respiratory tract infections are viral and do not require antibiotics at all 1
- Do not use standard adult formulations for pediatric patients: This can lead to dosing errors 3
- Ensure completion of the full course: Failure to complete antibiotics may result in recurrence of infection 3