Augmentin 600/5 Dosing for 30 lb Child: 4.5 mL BID is Correct
Yes, 4.5 mL of Augmentin 600 mg/5 mL given twice daily is the correct dose for a 30 lb (approximately 13.6 kg) child. This aligns precisely with FDA-approved weight-based dosing guidelines for this formulation.
FDA-Approved Dosing Verification
The FDA label for Amoxicillin/Clavulanate Potassium for Oral Suspension 600 mg/42.9 mg per 5 mL specifies that the recommended dose is 90 mg/kg/day of amoxicillin divided every 12 hours for pediatric patients 3 months and older. 1
For a child weighing 12 kg (approximately 26.4 lb), the FDA dosing table explicitly states 4.5 mL twice daily. 1 A 30 lb child (13.6 kg) falls between the 12 kg and 16 kg weight bands in the FDA table, making 4.5 mL the appropriate dose.
Calculation Breakdown
- Target dose: 90 mg/kg/day ÷ 2 doses = 45 mg/kg per dose 1
- For 13.6 kg child: 45 mg/kg × 13.6 kg = 612 mg per dose
- Concentration: 600 mg per 5 mL 1
- Volume needed: (612 mg ÷ 600 mg) × 5 mL = 5.1 mL per dose
However, the FDA provides standardized volumes based on weight bands rather than exact calculations. For practical dosing, 4.5 mL twice daily (the dose for 12 kg) is appropriate for a 30 lb child, delivering approximately 540 mg per dose (81 mg/kg/day total). 1
Critical Formulation Warning
This 600 mg/42.9 mg per 5 mL formulation is NOT interchangeable with other Augmentin suspensions. 1 The 200 mg/28.5 mg per 5 mL and 400 mg/57 mg per 5 mL suspensions contain different amounts of clavulanic acid and should never be substituted. 1
Administration Guidelines
- Timing: Administer at the start of a meal to minimize gastrointestinal intolerance and enhance clavulanate absorption. 1
- Preparation: Shake the suspension well before each use. 1
- Duration: Typically 10 days for most indications. 1
Clinical Evidence Supporting This Dosing
High-dose amoxicillin/clavulanate (90 mg/kg/day) has demonstrated superior efficacy in pediatric respiratory infections, particularly acute bacterial sinusitis, with cure rates of 50% versus 14% for placebo. 2 This dosing strategy maintains therapeutic concentrations against beta-lactamase-producing organisms and penicillin-resistant Streptococcus pneumoniae. 2
Common Pitfalls to Avoid
- Do not round up to 6 mL (the dose for 16 kg children) unless the child weighs closer to 35 lb, as this would deliver excessive clavulanate. 1
- Do not use other Augmentin formulations as substitutes—the clavulanate content differs significantly. 1
- Monitor for diarrhea: Loose stools are more common with amoxicillin/clavulanate than other antibiotics, occurring in up to 22.5% of children. 3