Augmentin Dosing for a 95-Pound Pediatric Patient
For a 95-pound (43 kg) patient who weighs ≥40 kg, use adult dosing of Augmentin rather than pediatric weight-based calculations. 1
Weight-Based Dosing Threshold
- Pediatric patients weighing 40 kg or more should be dosed according to adult recommendations, not pediatric weight-based formulas. 2, 1
- At 95 pounds (43 kg), this patient exceeds the 40 kg threshold and therefore requires adult dosing regimens. 2, 1
- The American College of Chest Physicians emphasizes verifying that adult dosing is used for patients ≥40 kg to avoid dosing errors that could result from applying pediatric calculations. 3
Standard Adult Dosing Regimens
The appropriate dose depends on infection severity and type:
For Mild to Moderate Infections
- Standard dose: 500 mg/125 mg tablet every 12 hours 1
- Alternative: 250 mg/125 mg tablet every 8 hours 1
For Severe Infections or Respiratory Tract Infections
- Preferred dose: 875 mg/125 mg tablet every 12 hours 1
- Alternative: 500 mg/125 mg tablet every 8 hours 1
For High-Risk Respiratory Infections
- High-dose regimen: 2000 mg/125 mg twice daily for patients with recent antibiotic use (within 4-6 weeks), moderate to severe disease, or areas with high prevalence of penicillin-resistant Streptococcus pneumoniae (>10%). 3
Critical Dosing Considerations
- The 250 mg/125 mg adult tablets should not be used until the child weighs at least 40 kg due to different amoxicillin-to-clavulanate ratios compared to pediatric formulations. 1
- Two 250 mg/125 mg tablets cannot substitute for one 500 mg/125 mg tablet, as both contain the same amount of clavulanic acid (125 mg), making them non-equivalent. 1
- Augmentin may be taken without regard to meals, though absorption of clavulanate is enhanced when taken at the start of a meal, which also minimizes gastrointestinal intolerance. 1
Treatment Duration
- Continue treatment for a minimum of 48-72 hours beyond symptom resolution or evidence of bacterial eradication. 4
- For respiratory infections, typical duration is 7-10 days. 2
- For Streptococcus pyogenes infections, treat for at least 10 days to prevent acute rheumatic fever. 4
Common Pitfalls to Avoid
- Do not apply pediatric weight-based calculations (45-90 mg/kg/day) to patients ≥40 kg, as this leads to incorrect dosing and potential treatment failure. 2, 3
- Verify the patient's weight in kilograms (43 kg) to confirm they meet the adult dosing threshold. 3
- For patients with difficulty swallowing tablets, adult-strength oral suspensions (200 mg/28.5 mg per 5 mL or 400 mg/57 mg per 5 mL) may substitute for tablets. 1