From the Guidelines
For a 32-pound child with otitis media, the recommended dose of Augmentin (amoxicillin-clavulanate) is 90 mg/kg per day of amoxicillin, with 6.4 mg/kg per day of clavulanate, divided into two doses, as per the guidelines from the Pediatrics journal 1.
Calculating the Dose
To calculate the dose, we need to first determine the child's weight in kilograms. Since the child weighs 32 pounds, we can convert this to kilograms by dividing by 2.2, which gives us approximately 14.5 kg.
- The recommended dose of amoxicillin is 90 mg/kg per day, so for a 14.5 kg child, the dose would be 90 mg/kg * 14.5 kg = 1305 mg per day.
- The recommended dose of clavulanate is 6.4 mg/kg per day, so for a 14.5 kg child, the dose would be 6.4 mg/kg * 14.5 kg = 92.8 mg per day.
- Since the dose should be divided into two doses, the child would need to take 1305 mg / 2 = 652.5 mg of amoxicillin and 92.8 mg / 2 = 46.4 mg of clavulanate per dose.
Administration and Side Effects
- The most appropriate formulation would be Augmentin 600mg/5mL suspension (or 400mg/5mL), but since this is not available, Augmentin 200mg/5mL or 400mg/5mL suspension could be used at a dose that achieves the calculated amount of amoxicillin and clavulanate per dose.
- It's essential to complete the full course of antibiotics even if symptoms improve before completion.
- Augmentin should be given with food to minimize gastrointestinal side effects, which can include diarrhea, nausea, and rash.
- The effectiveness of Augmentin in treating otitis media is due to the combination of amoxicillin with clavulanic acid, which helps overcome resistance from beta-lactamase-producing bacteria commonly found in ear infections, as noted in the Pediatrics journal guidelines 1.
From the Research
Otitis Media Treatment with Augmentin
The treatment of otitis media with Augmentin (amoxicillin-clavulanate) is a common practice, especially in cases where there is a risk of infection by β-lactamase-producing bacteria 2.
- The recommended dosage of amoxicillin, a component of Augmentin, is 90 mg/kg/day, divided into three doses, though two doses may be considered to improve compliance 2.
- For a child weighing 32 pounds (approximately 14.5 kg), the calculated dosage would be around 1305 mg per day, assuming the 90 mg/kg/day recommendation.
- However, it's crucial to follow the specific prescription instructions provided by a healthcare professional, as they may adjust the dosage based on the child's specific condition and response to the medication.
Efficacy of Short-Course Antibiotic Treatment
Several studies have investigated the efficacy of short-course antibiotic treatment for acute otitis media:
- A meta-analysis found that 5 days of short-acting antibiotic use is effective treatment for uncomplicated acute otitis media in children, with comparable outcomes to longer treatment durations 3.
- Another study suggested that a short course of antibiotics (<4 days) does not increase the risk of treatment failure until one month, although the use of short-acting oral antibiotics in short-course regimens may be associated with a higher risk of treatment failure 4.
- A systematic review of randomized controlled trials found that short-course antibiotics (less than seven days) have a higher risk of treatment failure compared to long-course antibiotics (seven days or more), but the difference is minimal, and the risk of gastrointestinal adverse events is lower with short-course treatment 5.
Considerations for Augmentin Treatment
When considering Augmentin treatment for otitis media:
- The choice of antibiotic should be based on the severity of the infection, the child's age, weight, and medical history, as well as the likelihood of β-lactamase-producing bacteria being present 2.
- A 5-day duration of therapy is often advised for uncomplicated acute otitis media, but the specific treatment duration should be determined by a healthcare professional based on the child's response to the medication and the severity of the infection 2.