What is the recommended dosage of amoxicillin (Amoxicillin) for an upper respiratory tract infection?

From the Guidelines

The recommended dosage of amoxicillin for an upper respiratory infection is 1.5-4 g/day, with lower daily doses (1.5 g/day) suitable for mild disease and higher daily doses (4 g/day) recommended for moderate disease or areas with high prevalence of penicillin-resistant S pneumoniae. When determining the appropriate dosage, it's crucial to consider the severity of the disease and the patient's risk factors for infection with resistant pathogens, as outlined in the guidelines for antimicrobial treatment of acute bacterial rhinosinusitis 1. Key factors influencing the choice of dosage include:

• Disease severity: Mild, moderate, or severe
• Recent antimicrobial use: Within the past 4-6 weeks
• Risk of resistant pathogens: Such as penicillin-resistant S pneumoniae
• Patient-specific factors: Including history of antibiotic use and clinical presentation The total daily dose of amoxicillin can vary, but higher daily doses (4 g/day) may be advantageous in areas with a high prevalence of penicillin-resistant S pneumoniae or for patients with moderate disease 1. It's essential to note that the determination of disease severity lies with the clinician's evaluation of the patient's history and clinical presentation 1, and antibiotic choices should be based on risk factors, including recent antibiotic use 1. Always consult with a healthcare provider to ensure proper diagnosis and appropriate treatment, as not all upper respiratory infections require antibiotics, and many are viral in nature.

From the FDA Drug Label

In Adults, 750 to 1750 mg/day in divided doses every 8 to 12 hours In Pediatric Patients over 3 Months of Age, 20 to 45 mg/kg/day in divided doses every 8 to 12 hours. Table 1 ... Ear/Nose/Throat ... Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours Table 1 ... Ear/Nose/Throat ... Severe 875 mg every 12 hours or 500 mg every 8 hours

The recommended dosage of amoxicillin for an upper respiratory infection is:

• For adults: 750 to 1750 mg/day in divided doses every 8 to 12 hours
• For pediatric patients over 3 months of age: 20 to 45 mg/kg/day in divided doses every 8 to 12 hours
• Specifically for ear/nose/throat infections:
  • Mild/Moderate: 500 mg every 12 hours or 250 mg every 8 hours
  • Severe: 875 mg every 12 hours or 500 mg every 8 hours 2

From the Research

Dosage of Amoxicillin for Upper Respiratory Infections

• The recommended dosage of amoxicillin for upper respiratory infections varies depending on the specific condition and patient population.
• For adult respiratory tract infections, a pharmacokinetically enhanced tablet dosage form of amoxicillin/clavulanate 2000/125 mg twice daily has been developed for use in cases due to drug-resistant pathogens 3.
• In pediatric cases, amoxicillin/clavulanate 90/6.4 mg/kg/day in two divided doses is recommended for persistent or recurrent acute otitis media where there are risk factors for the involvement of beta-lactamase-producing strains or S. pneumoniae with reduced penicillin susceptibility 3.
• A study from 1981 used a fixed combination of amoxicillin and clavulanic acid, with 750 mg of the drug combination (500 mg amoxicillin/250 mg clavulanic acid) given three times a day for seven or ten days to treat respiratory tract infections caused by amoxicillin-resistant Haemophilus influenzae 4.
• The South African medical journal guidelines recommend a dose of 90 mg/kg/day of amoxicillin for acute otitis media and acute bacterial sinusitis, which should be effective for pneumococci with high-level penicillin resistance 5.

Specific Patient Populations

• For children, a dose of 90 mg/kg/day of amoxicillin is recommended, particularly in those under 2 years of age, day-care attendees, cases with prior acute otitis media within the past 6 months, and children who have received antibiotics within the last 3 months 5.
• In cases of bacterial infections of the upper respiratory tract in childhood, a comparative clinical trial found amoxicillin-clavulanic acid combination to be highly effective, with eradication of the pathogenic agent in 90% of cases 6.

General Principles

• Antibiotic treatment of adults with nonspecific upper respiratory tract infections does not enhance illness resolution and is not recommended, unless there are complicating comorbid conditions or specific bacterial infections are suspected 7.