From the Guidelines
For a 51-pound (approximately 23 kg) child, the recommended azithromycin dose is 12 mg/kg once daily, with a maximum of 500 mg, for 5 days, as indicated for infections such as strep throat 1. This means the child should receive approximately 276 mg (12 mg/kg x 23 kg) once daily for 5 days.
Important Considerations
- Azithromycin is available as oral suspension (100 mg/5 mL or 200 mg/5 mL), tablets (250 mg, 500 mg), or Z-pak (pre-packaged course) 1.
- The suspension is typically preferred for children.
- Azithromycin works by inhibiting bacterial protein synthesis and should be given with or without food consistently.
- Common side effects include diarrhea, nausea, and abdominal pain.
- The medication should be stored at room temperature and suspension should be shaken well before measuring the dose with an appropriate measuring device.
Dosage Calculation
- For community-acquired pneumonia, the dose is 10 mg/kg on day 1, followed by 5 mg/kg on days 2-5, as per the guidelines 1.
- However, the more recent and higher-quality study 1 recommends a dose of 12 mg/kg once daily for 5 days for infections like strep throat, which takes precedence in this case.
Key Points
- Always follow the most recent and highest-quality guidelines when determining medication dosages.
- Azithromycin is a commonly used antibiotic for various infections in children.
- It is essential to consider the child's weight and the specific infection being treated when calculating the azithromycin dose.
From the FDA Drug Label
Based on Body Weight OTITIS MEDIA AND COMMUNITY-ACQUIRED PNEUMONIA: Weight KgLbs. 51
To calculate the dose, we need to determine which weight range the child falls into.
- 50 and above110 and above: 1500 mg for the 3-day or 5-day regimen for otitis media, acute bacterial sinusitis, and community-acquired pneumonia
- For pharyngitis/tonsillitis:
- 408812.5 mL (2½ tsp) 62.5 mL2500 mg
Since the child weighs 51 pounds, they fall into the 50 and above category. The recommended dose for otitis media, acute bacterial sinusitis, and community-acquired pneumonia is 1500 mg. The recommended dose for pharyngitis/tonsillitis is 2500 mg for the 5-day regimen, which is 12 mg/kg once daily for 5 days. To calculate the dose for pharyngitis/tonsillitis:
- 51 pounds is approximately 23.1 kg
- 12 mg/kg/day * 23.1 kg = 277.2 mg/day
- Total dose for 5 days: 277.2 mg/day * 5 days = 1386 mg So, the dose for pharyngitis/tonsillitis would be approximately 1386 mg for the 5-day regimen. However, according to the chart, the dose is 2500 mg for the weight range 40-81 lbs for pharyngitis/tonsillitis. Therefore, the dose for a 51-pound child with otitis media, acute bacterial sinusitis, or community-acquired pneumonia is 1500 mg, and for pharyngitis/tonsillitis is 2500 mg for the 5-day regimen, but a more accurate calculation based on weight is 1386 mg for the 5-day regimen, but this is not an option in the provided chart, so we will use 2500 mg as it is the recommended dose in the chart for the weight range. The final dose is:
- 1500 mg for otitis media, acute bacterial sinusitis, and community-acquired pneumonia
- 2500 mg for pharyngitis/tonsillitis 2
From the Research
Azithromycin Dosing for Children
To calculate the azithromycin dose for a 51-pound child, we need to consider the recommended dosage in terms of milligrams per kilogram of body weight.
- The child's weight in kilograms is approximately 23.1 kg (51 pounds / 2.2 pounds per kilogram).
- According to the study 3, azithromycin was administered at a dose of 10 mg/kg orally once daily for 3 days for the treatment of streptococcal pharyngitis in children.
- Using this dosage, the calculated dose for a 23.1 kg child would be 10 mg/kg * 23.1 kg = 231 mg per day.
- However, it's essential to note that the actual dosing may vary depending on the specific infection being treated and the clinical guidelines being followed.
Considerations
- The studies provided do not give a clear, universal dosage for azithromycin in children that can be applied across all infections.
- Dosage may need to be adjusted based on the type of infection, the child's age, and other factors, as indicated in studies 4, 5, 6, 7, 3.
- It's crucial to consult with a healthcare professional to determine the appropriate dosage for a specific child and infection.