Amoxicillin Dosing for a 14.79 kg Child
For a child weighing 14.79 kg, administer 6.7 mL of amoxicillin 250 mg/5 mL suspension twice daily (every 12 hours) for mild to moderate infections, or 13.3 mL twice daily for severe infections or high-risk scenarios.
Weight-Based Dose Calculation
Standard-Dose Regimen (45 mg/kg/day)
- For uncomplicated respiratory tract infections, skin infections, or genitourinary infections, the recommended dose is 45 mg/kg/day divided into 2 doses 1, 2.
- Calculation: 14.79 kg × 45 mg/kg/day = 665 mg/day total
- Per dose: 665 mg ÷ 2 = 332.5 mg per dose
- Volume: 332.5 mg ÷ 50 mg/mL = 6.7 mL twice daily 1, 3
High-Dose Regimen (90 mg/kg/day)
- High-dose amoxicillin is indicated when any of the following risk factors are present 1, 2:
- Age < 2 years
- Daycare attendance
- Recent antibiotic use (within past 30 days)
- Geographic area with >10% penicillin-resistant Streptococcus pneumoniae
- Moderate-to-severe illness presentation
- Community-acquired pneumonia
- Calculation: 14.79 kg × 90 mg/kg/day = 1,331 mg/day total
- Per dose: 1,331 mg ÷ 2 = 665.5 mg per dose
- Volume: 665.5 mg ÷ 50 mg/mL = 13.3 mL twice daily 1, 4
Indication-Specific Dosing Algorithm
Community-Acquired Pneumonia
- Always use high-dose: 90 mg/kg/day (13.3 mL twice daily) for 10 days 1, 4
- This regimen provides adequate coverage against penicillin-resistant S. pneumoniae and maintains therapeutic concentrations 1
Group A Streptococcal Pharyngitis
- Use 50–75 mg/kg/day divided into 2 doses for 10 days 1
- Calculation: 14.79 kg × 50 mg/kg = 740 mg/day (7.4 mL twice daily)
- Maximum single dose: Do not exceed 1,000 mg per dose 1
Acute Otitis Media
- Standard-dose (45 mg/kg/day): Use for children ≥2 years without recent antibiotic exposure 1, 2
- High-dose (90 mg/kg/day): Use for children <2 years, daycare attendees, or recent antibiotic use within 4–6 weeks 1, 5
Acute Bacterial Sinusitis
- Standard-dose: 45 mg/kg/day for children ≥2 years without risk factors 1
- High-dose: 80–90 mg/kg/day for children <2 years or with risk factors 1
Treatment Duration & Monitoring
Duration Guidelines
- Respiratory infections: 7–10 days, with pneumonia requiring the full 10 days 1, 2
- Group A Streptococcal infections: Complete 10-day course to prevent acute rheumatic fever 1, 3
- Continue therapy for at least 48–72 hours after complete symptom resolution 1
Expected Clinical Response
- Children should demonstrate clinical improvement within 48–72 hours of initiating appropriate therapy 1, 2
- If no improvement occurs within this timeframe, reevaluation and further investigation are necessary 1
- For pneumonia, fever typically resolves within 24–48 hours, though cough may persist longer 1
Administration Instructions
Proper Dosing Technique
- Shake the suspension vigorously before each dose 3
- Administer at the start of a meal to minimize gastrointestinal intolerance 3
- The suspension may be placed directly on the child's tongue or mixed with formula, milk, fruit juice, or water and taken immediately 3
Storage & Stability
- After reconstitution, discard any unused suspension after 14 days 3
- Refrigeration is preferable but not required 3
- Keep bottle tightly closed 3
Critical Considerations & Common Pitfalls
When to Escalate to Amoxicillin-Clavulanate
- Switch to amoxicillin-clavulanate (90 mg/kg/day of amoxicillin component) when β-lactamase-producing organisms (H. influenzae, M. catarrhalis) are suspected 1
- Consider for children with incomplete H. influenzae type b vaccination or concurrent purulent acute otitis media 1
Maximum Dosing Limits
- Maximum daily dose: 4,000 mg/day regardless of weight 1
- For this 14.79 kg child, even the high-dose regimen (1,331 mg/day) is well below this maximum 1
Penicillin Allergy Alternatives
- Non-anaphylactic allergy: Second- or third-generation cephalosporins (cefdinir, cefuroxime) 1
- Type I (IgE-mediated) allergy: Clindamycin 10–20 mg/kg/day in 3 doses or azithromycin 12 mg/kg once daily for 5 days 1