Augmentin Pediatric Dose Calculator

Standard Augmentin provides 25 mg/kg/day of the amoxicillin component, suitable for mild infections. High-dose Augmentin at 45 mg/kg/day is recommended by the AAP for acute otitis media and sinusitis where penicillin-resistant S. pneumoniae is prevalent. The higher amoxicillin concentration achieves better middle ear fluid levels to overcome resistant bacteria.

The ES (extra strength) 600 mg/5 mL formulation is specifically designed for high-dose therapy at 90 mg/kg/day. It has a lower clavulanate-to-amoxicillin ratio (42.9 mg clavulanate per 600 mg amoxicillin vs 28.5 mg per 200 mg in standard), which prevents the GI side effects that would occur if standard formulations were used at these high amoxicillin doses. It should only be dosed BID.

Diarrhea is the most common side effect of Augmentin, caused primarily by the clavulanate component disrupting gut flora. The risk increases with higher clavulanate doses, which is why the ES formulation was developed with a lower clavulanate ratio. Giving the medication with food and using probiotics may help reduce GI symptoms. If severe diarrhea develops, contact the prescriber.

Yes, reconstituted Augmentin suspension must be refrigerated and is typically stable for 10 days after mixing. The pharmacy will add water at dispensing. Shake the bottle well before each dose. Discard any remaining suspension after 10 days even if there is medication left. Tablets do not require refrigeration and can be stored at room temperature.

No, Augmentin contains amoxicillin which is a penicillin-class antibiotic. Children with a confirmed penicillin allergy should not take Augmentin. The cross-reactivity with cephalosporins is approximately 1-2%, so some cephalosporins may be alternatives depending on the type of penicillin reaction. Always consult the prescriber for appropriate alternatives.

Yes, Augmentin should be taken at the beginning of a meal to enhance absorption of the clavulanate component and reduce gastrointestinal side effects. Taking it with food does not significantly affect amoxicillin absorption but improves tolerability. For young children, the suspension can be mixed with a small amount of milk or formula immediately before administration.

For standard and high-dose regimens, the maximum is generally 875 mg amoxicillin per dose given BID (1750 mg/day). For the ES-600 formulation used at 90 mg/kg/day, the maximum is 2000 mg amoxicillin per dose BID (4000 mg/day). These caps correspond to adult dosing limits. The clavulanate component should not exceed 6.4 mg/kg/day to minimize GI side effects.