Antimicrobials
Amoxicillin-Clavulanate

Amoxicillin-Clavulanate

Dosing

30 mg/kg/day (of amoxicillin component) divided Q12H

15 mg/kg/day (of amoxicillin component) once daily

Daily Dose: 45 - 60 mg/kg/day of amoxicillin component

Maximum Daily Dose: 4000 mg/day amoxicillin component

Dosing Frequency: PO divided TIDFor a child weighing < 35 kg

Use suspension. Specify 400 mg/5mL suspension of 7:1 formulation to minimize risk of diarrhea.For a child weighing ≥ 35 to < 40 kg

Use 500 mg tablets PO TID or suspension. Specify 400 mg/5mL suspension of 7:1 formulation to minimize risk of diarrhea.For a child weighing ≥ 40kg

Use 875mg tablet PO TID or suspension. Specify 400mg/5mL suspension or 7:1 formulation to minimize risk of diarrhea

If patient unable to swallow whole tablets, tablet may split in half. Tablets may also be crushed and mixed with a small amount of water, milk or food if taken immediately.

Note dosing is for 5:1 formulation only

  • < 3 months: 25 mg/kg/dose IV every 12 hours

  • ≥ 3 months: 25 mg/kg/dose IV every 8 hours

Maximum dose: 1000mg

General Information

  • Hepatotoxicity (cholestatic or mixed ) due to clavulanate

  • Diarrhea 9% (due to clavulanate component)

  • Non-allergic rash

  • Cytopenias with prolonged use

Oral

  • Prophylaxis or treatment of a human or animal bite wound

  • Children with AOM (BID or preferably TID) who have taken Amoxicillin in the prior 30 days

  • Persistent or AOM not responding to Amoxicillin therapy

  • Chronic sinusitis as provided coverage for possible beta-lactamase positive H. influenzae and M. catarrhalis and/or S. aureus

IV

  • Empiric prophylaxis and treatment of animal and human bite wounds

  • Empiric treatment of chronic sinusitis requiring IV therapy as an alternative to cefuroxime

  • Treatment of pneumonia in patients with suspected or proven Moraxella catarrhalis or H. influenzae resistant to ampicillin

  • Treatment of complicated appendicitis in patients who have received aminoglycosides ≥ 8 days and who do not have resistant pathogens isolated

Concentration: 400 mg/5 mL of 7:1 formulation

Taste: Good

Not all strengths of oral liquids are listed nor be available on the CHEO Formulary

  • 500 mg amoxicillin component

  • 875 mg amoxicillin component

Tablets or capsules are preferred especially over an unpleasant tasting oral liquid.

Not all strengths of oral tablets/capsules are listed and they are not all available on the CHEO Formulary