From the Guidelines
For a 20kg child with otitis media, the recommended dose of amoxicillin is 40 mg kg−1 BD for 5 days, which equals approximately 800 mg twice daily. This dosage is based on the World Health Organization's guidelines for antibiotic prescribing in children, as outlined in the study published in the British Journal of Pharmacology 1. The study provides a clear recommendation for the treatment of otitis media with amoxicillin, emphasizing the importance of proper dosing to ensure effective treatment and minimize the risk of antibiotic resistance.
When calculating the dose, it is essential to consider the child's weight and the recommended dosage per kilogram. In this case, the child weighs 20kg, and the recommended dose is 40 mg kg−1 BD, resulting in a total daily dose of 800 mg, divided into two doses of 400 mg each. This dosage should be administered for a duration of 5 days, as specified in the guidelines.
It is crucial to note that the dosage and duration of treatment may vary depending on the severity of the infection and the presence of any underlying medical conditions. However, based on the available evidence, the recommended dose of 40 mg kg−1 BD for 5 days is the most appropriate treatment for a 20kg child with otitis media, as supported by the study published in the British Journal of Pharmacology 1.
Some key points to consider when administering amoxicillin to a child with otitis media include:
- The medication should be taken consistently at 12-hour intervals to maintain adequate blood levels.
- The child should complete the full course of antibiotics, even if symptoms improve before the medication is finished.
- If the child develops a rash, severe diarrhea, or shows no improvement after 48-72 hours, they should contact their healthcare provider.
- Amoxicillin works by inhibiting bacterial cell wall synthesis, causing bacterial cell death, and is effective against a range of bacterial infections, including those caused by Streptococcus pneumoniae, a common causative organism in otitis media.
From the Research
Amoxicillin Dosage for Otitis Media in Children
- The proper dose of amoxicillin for a 20kg child with otitis media is not explicitly stated in the provided studies, but we can look at the recommended dosages from the studies.
- According to the study 2, amoxicillin suspension was given in a dose of 20 mg/kg (maximum, 750 mg) twice daily for 7 to 10 days.
- For a 20kg child, the dose would be 20 mg/kg * 20 kg = 400 mg twice daily, which is within the maximum recommended dose of 750 mg.
- Another study 3 mentions that the American Academy of Pediatrics recommends a high-dose amoxicillin for the treatment of acute uncomplicated otitis media, with a dose of 80 to 90 mg/kg per day.
- For a 20kg child, the dose would be 80 mg/kg * 20 kg = 1600 mg per day, or 90 mg/kg * 20 kg = 1800 mg per day, which is higher than the standard adult dose of 1500 mg/d.
Considerations for Dosage
- The study 3 also notes that primary care physicians often prescribe a lower-than-recommended dose of amoxicillin for older children and those in higher weight categories.
- The opinion among subcommittee members regarding maximum dose specification of amoxicillin is varied, with some recommending the standard adult dose and others recommending the recommended dose of 80 to 90 mg/kg per day 3.
- It's worth noting that the efficacy and safety of amoxicillin compared to other antibiotics, such as azithromycin, have been studied in several trials 4, 5, 6, but the optimal dosage for a 20kg child with otitis media is not explicitly stated in these studies.