how to prescribe pediatric amoxicillin--please help

[chloroform2009]

I'm not a pharmacist so please don't flame me for the below questions, for which I need to know because I'm trying to figure something out.

1) Suppose we have a 40 kg child and we want to prescribe amoxicillin in liquid suspension at 20 mg/kg/day in divided doses every 8 hours.

Rx: Amoxicillin 250mg/5ml; Disp: 105 ml ; Sig: 1 tsp TID for 7 days

Is this correct?

2) With the same kid, suppose we're trying to rx 40mg/kg/day in divided doses of every 12 hours.

Rx: Amoxicillin 400mg/5ml; Disp:140 ml; Sig: 2 tsps each BID for 7 days

Is this also correct?

3) Pediatric dosages are not supposed to be higher than adult doses. Does this mean that pediatric doses can't go above ~2 g/day ( which is the typical standard adult amoxicillin regimen )?

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[Praziquantel86]

The first two are correct, with a minor exception. Leave the dispense amount off, as pharmacies dispense in whole-bottle quantities. They'll figure out the amount they need to dispense in order to cover the directions.

The third statement is also correct. You'll almost never go above the adult dosing range (there are very few exceptions, but amoxicillin isn't one of them).

 

[npage148]

Yeah, keep the daily dose under 2625 (875mg tid). Please no 1200 mg tid. Aiming for 90mg/kg/day in a 40kg kid. I don't want to call you and discuss how the PDA told you the dose and that you don't see anything wrong with it.

 

[chloroform2009]

Yeah, keep the daily dose under 2625 (875mg tid). Please no 1200 mg tid. Aiming for 90mg/kg/day in a 40kg kid. I don't want to call you and discuss how the PDA told you the dose and that you don't see anything wrong with it.

Would any kid ( no matter what age or weight) be fine with an amoxicillin rx that is up to that amount ?

Do children routinely die from amoxicillin overdose? What about overdose from other antibiotics?

 

[PharMed2016]

Would any kid ( no matter what age or weight) be fine with an amoxicillin rx that is up to that amount ?

Do children routinely die from amoxicillin overdose? What about overdose from other antibiotics?

http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm

All the information you may need is here.

 

[BMadjuster]

Would any kid ( no matter what age or weight) be fine with an amoxicillin rx that is up to that amount ?

Do children routinely die from amoxicillin overdose? What about overdose from other antibiotics?

What do you want this information for?

 

[J ROD]

what do you want this information for?

hw....

 

[MountainPharmD]

J Dub what did you do to get put on probation?

 

[BMadjuster]

J Dub what did you do to get put on probation?

He hurt my feelings.

 

[J ROD]

J Dub what did you do to get put on probation?

check my profile page....

 

[J ROD]

He hurt my feelings.

 

[MountainPharmD]

check my profile page....

J Dub......tsk, tsk, tsk.....Don't you know the fastest way to get banned is to venture over to the other side and start calling them names. sdn1977 was one of the best contributors on here and she got banned for getting into a pissing contest with one of the resident/admins. You have to be carefull!

 

[WVUPharm2007]

Would any kid ( no matter what age or weight) be fine with an amoxicillin rx that is up to that amount ?

Do children routinely die from amoxicillin overdose? What about overdose from other antibiotics?

Nothing too terrible. Seizure is possible in some patients if you pump them full of too much amoxil. What you'd see more often is God-awful diarrhea. Which in a sick child might be a thing you don't want to risk if they are already dehydrated. And, yeah, assuming the bug is susceptible, 90mg/kg should be fine for anything...its really only used for sinusitis and otitis...and the occasional weird situation that involves altered tissue penetration...

And other abx...depends on the agent...obviously toxic agents like aminoglycosides, ampho b, and vanc can be devastating in acute overdose...

 

[Old Timer]

We have been down this road before. As far as drugs go Amoxicillin is as close to non-toxic as you get. At 90mg/kg if you have your fictitious 70 kg man that would be 6300mg/day or 2100mg tid.

There really is no way to OD on Amoxicillin unless you have a small child and a huge error in reporting his/her weight. Until people evolve to get a cell wall you can pretty much give as much amoxicillin as you want w/o worry...

 

[PumpkinSmasher]

We have been down this road before. As far as drugs go Amoxicillin is as close to non-toxic as you get. At 90mg/kg if you have your fictitious 70 kg man that would be 6300mg/day or 2100mg tid.

There really is no way to OD on Amoxicillin unless you have a small child and a huge error in reporting his/her weight. Until people evolve to get a cell wall you can pretty much give as much amoxicillin as you want w/o worry...

I can not wait until my cells have walls...