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, and has a narrow microbiologic spectrum 1. The choice of amoxicillin as first-line therapy for acute otitis media (AOM) is due to its efficacy, safety, and acceptable taste. Some key points to consider when prescribing amoxicillin for ear infections include:
- The dosage should be weight-based for children, with 80-90 mg/kg/day being the recommended range
- The optimal duration of therapy for patients with AOM is uncertain, but typical treatment courses last 5-10 days
- If the patient is allergic to amoxicillin, alternative antibiotics such as cefdinir, cefpodoxime, or cefuroxime may be prescribed instead, as long as the allergic reaction is not a type I hypersensitivity reaction 1. It's essential to note that amoxicillin should be taken as directed, and the full course of antibiotics should be completed even if symptoms improve before finishing the prescription.
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.