From the Guidelines
For ear infections, the recommended amoxicillin dose is 80 to 90 mg per kg per day. This dosage is based on the most recent and highest quality study available, which suggests that this dose is effective against susceptible and intermediate resistant pneumococci, with a preponderance of benefit over risk 1.
Key Considerations
- The choice of amoxicillin as first-line therapy is due to its effectiveness, safety, and narrow microbiologic spectrum.
- The optimal duration of therapy for patients with ear infections is uncertain, but treatment is typically given for 5-10 days.
- It is essential to complete the full course of antibiotics even if symptoms improve before finishing.
Important Details
- Amoxicillin is recommended as first-line therapy for ear infections because it is generally effective when used in sufficient doses against susceptible and intermediate resistant pneumococci.
- If the patient is allergic to amoxicillin and the allergic reaction is not a type I hypersensitivity reaction, alternative antibiotics such as cefdinir, cefpodoxime, or cefuroxime can be prescribed.
- The dosage of 80 to 90 mg per kg per day is based on extrapolation from microbiologic studies and expert opinion, with a focus on maximizing the effectiveness of the treatment while minimizing the risk of adverse effects 1.
From the Research
Amoxicillin Dose for Ear Infections
- The recommended dose of amoxicillin for ear infections, specifically acute otitis media (AOM), is 80-90 mg/kg/day 2.
- This dose is considered high-dose amoxicillin and is recommended as the first-line therapy for AOM 2.
- A study comparing high-dose amoxicillin to standard-dose amoxicillin found no significant difference in treatment success or adverse effects between the two doses 3.
- Another study compared azithromycin to co-amoxiclav for the treatment of AOM and found that azithromycin was as effective as co-amoxiclav, with fewer adverse events 4.
- The choice of antibiotic for AOM should consider factors such as pharmacokinetic data, bacteriologic cure, and potential perturbations of nasopharyngeal colonization 5.
- Alternative agents, such as azithromycin, may be considered for the treatment of AOM, especially in cases where amoxicillin is not effective or is not tolerated 4, 5.