Drug

Typical Dosing

Amoxicillin/clavulanate

Augmentin^®

Pregnancy: B; Lactation: Consider Alt

Q12H Formulations:

Tabs: 1000mg /65.3 mg

Chewable Tabs:

200 mg/28.5 mg, 400 mg/57 mg

Oral Susp:

Q8H Formulations:

Tabs:250 & 500 mg/125 mg

Oral Susp: 125 mg/31.25 mg/5 mL

250 mg/62.5 mg/5 mL

Augmentin ES-600 powder for oral suspension with increased ratio amoxicillin to clavulanic acid for treatment of pediatric patients with recurrent or persistent acute otitis media due to S. pneumoniae, H. influenzae, or M. catarrhalis.

Dosing: Based on Amoxicillin Component

Neonates and infants <3 months: 125 mg/5 mL suspension

30 mg/kg/day in divided doses Q12H.

Children ≥3 months up to 40 kg: Oral Suspension or Chewable Tablet

25-45 mg/kg/day in divided doses Q12H using a Q12H formulation.

20-40 mg/kg/day in divided doses Q8H using a Q8H formulation.

Multidrug-resistant S. pneumonia otitis media:

80-90 mg/kg/day in divided doses Q12H.

Q12H using 200 mg/5 mL susp or 200-mg chewable tablet @ 45 mg/kg/day

9 kg (20 lb) = 1 tsp (or tab) (5 mL) Q12H

13 kg (29 lb) = 1¹/₂ tsp (or tab) (7.5 mL) Q12H

18 kg (40 lb) = 2 tsp (or tabs) (10 mL) Q12H

Q12H using 400 mg/5 mL susp or 400-mg chewable tablet @ 45 mg/kg/day

18 kg (40 lb) = 1 tsp (or tab) (5 mL) Q12H

27 kg (59 lb) = 1¹/₂ tsp (or tab) (7.5 mL) Q12H

35 kg (77 lb) = 2 tsp (or tabs) (10 mL) Q12H

>40 kg = Use adult dose (max 875 mg Q12H )

Q8H using 125 mg/5 mL susp or 125-mg chewable tablet @ 40 mg/kg/day

9 kg (21 lb) = 1 tsp (or tabs) (5 mL) Q8H

14 kg (31 lb) = 1¹/₂ tsp (or tab) (7.5 mL) Q8H

19 kg (42 lb) = 2 tsp (or tabs) (10 mL) Q8H

Q8H using 250 mg/5 mL susp or 250-mg chewable tablet @ 40 mg/kg/day

19 kg (42 lb) = 1 tsp (or tabs) (5 mL) Q8H

28 kg (62 lb) = 1¹/₂ tsp (or tab) (7.5 mL) Q8H

37 kg (81 lb) = 2 tsp (or tabs) (10 mL) Q8H

Q12H using 600 mg/5 mL ES-600 suspension for pediatric patients ≤40 kg with otitis media due to multi-drug resistant S. pneumoniae

8 kg (18 lb) = 3 mL Q12H

12 kg (26 lb) = 4.5 mL Q12H

16 kg (35 lb) = 6 mL Q12H

20 kg (44 lb) = 7.5 mL Q12H

24 kg (53 lb) = 9 mL Q12H

28 kg (62 lb) = 10.5 mL Q12H

32 kg (70 lb) = 12 mL Q12H

36 kg (79 lb) = 13.5 mL Q12H

Children ≥40 mg to Adult:

250 mg PO Q8H or 500 mg PO Q12H.

Severe or respiratory tract infection 500 mg PO Q8H or 875 mg PO Q12H

Food: Advise taking with food. May administer with or without meals, however GI intolerance and diarrhea may be reduced if taken with meals.

Side effects: Diarrhea (common), nausea, vomiting, rash, agitation, seizures, bleeding abnormalities, decreased WBC count, drug fever, superinfection.

Caution: May cause nonallergic maculopapular rash, especially in patients with viral infection, mononucleosis, or acute lymphocytic leukemia.

Use with caution in hepatic disease.

Reduce dose in renal disease:

CrCl 10-30 mL/min use a Q8H formulation Q12H

CrCl <10 mL/min use a Q8H formulation Q24H

Note: Q8H and Q12H formulations are not interchangeable due to different ratio of clavulanic acid. Two 250 mg/125 mg tablets are not equivalent to one 500 mg/125 mg tablet. 250 mg tablet is not equivalent to 250-mg chewable tablet. 200-mg and 400-mg suspensions and tablets contain phenylalanine and should be avoided in phenylketonurics.