Augmentin Dosing for an 11.34 kg Child
For a child weighing 11.34 kg, administer Augmentin at 45 mg/kg/day of the amoxicillin component divided into two doses (approximately 255 mg twice daily) for mild-to-moderate infections, or 90 mg/kg/day divided into two doses (approximately 510 mg twice daily) for severe infections, high pneumococcal resistance areas, or high-risk situations. 1, 2, 3
Weight-Based Calculation
- Standard-dose regimen: 11.34 kg × 45 mg/kg/day = 510 mg/day total, divided into 255 mg twice daily 1, 3
- High-dose regimen: 11.34 kg × 90 mg/kg/day = 1,020 mg/day total, divided into 510 mg twice daily 1, 2, 3
Practical Formulation Selection
- Using the 200 mg/5 mL suspension, the standard dose would be approximately 6.4 mL twice daily (255 mg per dose) 3
- Using the 200 mg/5 mL suspension, the high dose would be approximately 12.7 mL twice daily (510 mg per dose) 3
- Alternatively, using the 400 mg/5 mL suspension, the high dose would be approximately 6.4 mL twice daily 3
Indication-Based Dosing Algorithm
Use Standard Dose (45 mg/kg/day) When:
- Child is ≥2 years old with uncomplicated respiratory infection 1
- No recent antibiotic exposure within past 30 days 1
- Not attending daycare 1
- Mild-to-moderate infection severity 1, 3
Use High Dose (90 mg/kg/day) When ANY of These Apply:
- Child is <2 years old 1
- Recent antibiotic use within past 30 days 1
- Daycare attendance 1
- Geographic area with >10% penicillin-resistant S. pneumoniae 1
- Moderate-to-severe illness presentation 1
- Community-acquired pneumonia 1
- Recurrent or persistent acute otitis media after amoxicillin failure 4, 5
- Suspected β-lactamase-producing organisms (H. influenzae, M. catarrhalis) 1, 6
Treatment Duration
- 10 days for most respiratory infections including pneumonia, acute otitis media, and acute bacterial sinusitis 1, 2, 3
- Continue for at least 48-72 hours after complete symptom resolution 1
Clinical Monitoring
- Expect clinical improvement within 48-72 hours of initiating appropriate therapy 1, 2
- If no improvement or worsening after 48-72 hours, reevaluate for atypical pathogens, consider adding a macrolide, or escalate care 1
Administration Guidance
- Administer at the start of meals to enhance clavulanate absorption and minimize gastrointestinal intolerance 3
- The twice-daily regimen is preferred over three-times-daily dosing because it significantly reduces diarrhea incidence and improves compliance 3, 7
Critical Dosing Considerations
- The high-dose formulation (14:1 ratio) provides adequate clavulanate to inhibit β-lactamase producers while minimizing gastrointestinal side effects compared to other ratios 2, 5
- Do not substitute two 250 mg/125 mg tablets for one 500 mg/125 mg tablet, as clavulanate content differs 3
- For children <12 weeks old, use 30 mg/kg/day divided every 12 hours and preferentially use the 125 mg/5 mL suspension 3
Common Pitfalls to Avoid
- Underdosing when high-dose therapy is indicated leads to treatment failure against resistant organisms 2
- Using standard doses in high-risk situations (age <2 years, daycare, recent antibiotics) fails to achieve adequate coverage for penicillin-resistant S. pneumoniae 1
- Most upper respiratory infections are viral and do not require antibiotics—verify bacterial indication before prescribing 2