General Dosing
- Dosing based on amoxicillin component
- Max daily dose of oral amoxicillin is 4 g/day
- Max daily dose of oral clavulanate is 12.5 mg/kg/day (preferred 10 mg/kg/day)
Oral Route
Low dose: 40-50 mg/kg/DAY PO divided q8h
High dose: 80-90 mg/kg/DAY PO divided q12h
IV Route
Less than 3 months OR less than 4 kg:
- 5:1 formulation: 25 mg/kg/dose IV q12h (preferred dosing regimen)
- 10:1 formulation: 50 mg/kg/dose IV q12h (limited evidence)
Greater than 3 months and greater than 4 kg:
- 5:1 formulation: 25 mg/kg/dose IV q8h (max dose: 1000 mg) (preferred dosing regimen)
- 10:1 formulation: 50 mg/kg/dose IV q8h (max dose: 2000 mg) (limited evidence)
Skin and Soft Tissue Infections, UTI
Term to 3 mo
4:1 30mg/kg/DAY PO divided q12h
Infant 3 mo to child less than 40kg
- 4:1 25-45mg/kg/DAY PO divided q8h
- 7:1 25-45mg/kg/DAY PO divided q12h
Child/Adolescent greater than or equal to 40kg or greater than or equal to 16 years old
- 4:1 500mg PO q8-12h
- 7:1 875mg PO q12h
Acute Otitis Media, Sinusitis
Term to 3 mo:
4:1 30mg/kg/DAY PO divided q12h
Infant 3 mo to child less than 40kg
- 7:1 45-60mg/kg/DAY PO divided q8h
- 14:1 90mg/kg/DAY PO divided q8-12h (max 4g/day)
Child/Adolescent greater than or equal to 40kg or greater than or equal to 16 years old
- 4:1 500mg PO q8h
- 7:1 875mg PO q12h
Community Acquired Pneumonia
Term to 3 mo
4:1 30mg/kg/DAY PO divided q12h
Infant 3 mo to child less than 40kg
- 7:1 45-60mg/kg/DAY PO divided q8h
- 14:1 90mg/kg/DAY PO divided q8h (max 4g/day)
Child/Adolescent greater than or equal to 40kg or greater than or equal to 16 years old
- 4:1 500mg PO q8h
- 7:1 875mg PO q12h
How to order 14:1 Ratio of Amoxicillin/Clavulanic Acid
To achieve 90mg/kg/day at a 14:1 ratio, combine the following:
- Amoxicillin/Clavulanic Acid 7:1 formulation 45mg/kg/DAY PO divided q8-12h
WITH
- Amoxicillin 45mg/kg/DAY PO divided q8-12h
Example Order: Amox/Clav 200 mg (7:1 ratio) PO q8h WITH Amoxicillin 200 mg PO q8h for total 14:1 ratio
Amoxicillin-Clavulanate