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Amoxicillin For Kids: Formulations, Dose And Side Effects

Amoxicillin For Kids: Formulations, Dose And Side Effects

Amoxicillin is one of the most prescribed antibiotics in the UK. In this post, I will review all the essential information about the use of amoxicillin in children. ‘Amoxicillin for kids’ – the outline of the post:

AMOXICILLIN 
METRONIDAZOLE

Amoxicillin For Kids: Legal Status

Amoxicillin is a prescription-only medication (POM). The supply of POM medicines requires a prescription written by a GP or another authorized healthcare professional.

Forms Of Amoxicillin For Kids

All forms of amoxicillin antibiotics used in children come in as powder for oral suspension. When a prescription is brought to the pharmacy, a pharmacy team member mixes the powder with water to make a suspension.

Occasionally amoxicillin powder is given to patients/parents to mix at home when needed as requested by the prescriber or parents themselves. It is essential to follow the directions for the reconstitution, which are located on the bottle when mixing the powder with water.

The amount of water needed to prepare amoxicillin suspension may be different between various preparations of amoxicillin. Mixing the antibiotic with the incorrect amount of water will lead to an incorrect dose of the medication given to the patient. Most (but not all) amoxicillin preparations for children have a shelf life of 7 days when mixed with water.

Patients may be given one bottle of already mixed amoxicillin suspension and owe for another bottle (to collect at a different time) when the treatment duration is longer than seven days. Part supply is given to ensure that both bottlers of the antibiotic do not go out of date after the 7th day of the treatment. Patients may request to take the second bottle away with them to mix at home.

Different Strengths Of Amoxicillin For Kids Exist:

  • Amoxicillin 125mg/5ml Oral Suspension
  • Amoxicillin 125mg/5ml Oral Suspension sugar-free
  • Amoxicillin 250mg/5ml Oral Suspension
  • Amoxicillin 250mg/5ml Oral Suspension sugar-free

Amoxicillin is also available in combination with clavulanic acid, known as co-amoxiclav. It is available in a generic form and branded as Augmentin:

  • Co-amoxiclav 125 mg/31.25mg/5 ml Powder for Oral Suspension
  • Co-amoxiclav 250 mg/62.5 mg/5 ml Powder for Oral Suspension
  • Co-amoxiclav 400 mg/57mg/5ml Powder for Oral Suspension
  • Augmentin 125/31 Suspension
  • Augmentin 250/62 Suspension

Quick FAQ

What is the generic name of amoxicillin?
Amoxil (amoxicillin) is available as a generic drug termed amoxicillin.

What Flavor Does Amoxicillin For Kids Come In?

From time to time, parents ask if a specific formulation of amoxicillin suspension comes in a particular flavor. It is not possible to choose the flavor of a prescribed antibiotic.

Typical flavors of amoxicillin oral suspension include:

  • Orange
  • Lemon
  • Fruity
  • Banana

The above list of flavors comes from all formulations of amoxicillin suspension rather than one formulation. If information is needed on the flavor, speak to the pharmacy team before amoxicillin powder is reconstituted. Information on the flavor of liquid antibiotics is usually provided inside the information leaflet.

Pharmacies may store more than one version of amoxicillin, which may be of the same or different flavor.

Can You Mix Amoxicillin For Kids With Other Liquids, e.g., Milk, To Ease The Administration?

The above question is a popular question that parents ask in the pharmacy. Many formulations of antibiotics are unpleasant in taste, despite their artificial flavors.

None of the product information for amoxicillin suspension advises on whether it is ok to mix an antibiotic with other liquids such as milk or juices. One needs to think about the possible effect of juice or milk on the absorption of the drug (how much drug is into the body) as well as the impact on the dosing of the antibiotic. Is the child going to take the full dose when the antibiotic is mixed with another liquid?

Although many websites advise patients to speak to the pharmacist about mixing the antibiotic with other liquids, it is unlikely they will have a definite answer. Speaking to a GP may be a better choice.

Although most likely they will not know whether it is ok to mix liquid antibiotics for children with other liquids, they can give directions for the administration of medicines, even when they are not according to the product license (unlicensed use of medication).

What Is Amoxicillin For Kids Used For?


Amoxicillin is a broad-spectrum antibiotic used in the treatment of infections caused by a wide range of bacteria, including (non-exclusive list): 

  • Bacterial sinusitis
  • An infection of the middle ear (otitis media)
  • Tonsillitis with a bacterial infection
  • Community-acquired pneumonia
  • Cystitis
  • Dental infections

Please follow the instructions from your GP for dosage instructions. Check the dispensing label for dosage instructions. Dosage may be different and may depend on the severity of the infections and the type of infection treated.

Amoxicillin is usually taken three times a day (every eight hours).

The following doses are the recommended doses in the treatment of infections such as oral infections, sinusitis, or ear infection (NICE, 2020):

For Neonate 7 days to 28 days

The dose of amoxicillin is based on the weight of the baby:

30mg/kg 3 times a day (max. per dose 125 mg).

For children 1–11 months

125mg 3 times a day; increased if needed up to 30 mg/kg 3 times a day.

For children 1–4 years

250mg 3 times a day; increased if needed up to 30 mg/kg 3 times a day.

For children 5–11 years

500mg 3 times a day; increased if needed up to 30 mg/kg 3 times a day (max. per dose 1 g).

For children 12–17 years

500mg 3 times a day; increased if needed up to 1g, taken 3 times a day. The increased dose is used in severe infections.

The above doses are given in milligrams (mg) of amoxicillin. When prescribed, the treatment dose is usually given in milliliters (mL) of the antibiotic. For example, the following is prescribed for a 6-month baby:

Amoxicillin 125mg/5ml Oral Suspension

Dosage: Take 5mL three times a day for 5 days

The above dosage equals 125mg of amoxicillin taken three times a day.

Amoxicillin capsules

Amoxicillin for adults and adolescents is also available in the form of capsules. Each capsule contains 500mg of amoxicillin. Amoxicillin capsules are also available as 250mg capsules.

Quick FAQ

Is 500mg of amoxicillin too much for a child?
For children weighing 40 kilograms 500mg of amoxicillin per day can be prescribed.
Is amoxicillin the same as penicillin?
Amoxicillin is in the same family of antibiotics as penicillin

How Long Is Amoxicillin Taken?

Duration of treatment with amoxicillin is usually 5, 7, or 14 days; however, longer treatment may be necessary depending on the type of infection treated. Follow the GP’s directions and always complete the course of antibiotics, even if the symptoms are resolved.

Amoxicillin For Kids: Possible Side Effects

The use of amoxicillin is associated with potential side effects.

Common side effects may include:

  • Diarrhea
  • Nausea
  • Skin rash

Very rarely, amoxicillin can cause severe allergic reactions and anaphylaxis.

Storage And Expiry Dates

Storage of liquid antibiotics for children was discussed in another post – Antibiotics for children: refrigeration and expiry dates.

Storage Of Amoxicillin For Children

Once mixed with water, all forms of amoxicillin suspension need to be refrigerated (2°C-8°C).

Once made up, the amoxicillin solution usually has 7 days shelf life. However, some sugar-free versions of amoxicillin solutions for children have a shelf life of 14 days. Please check for expiry dates on the bottle of the product or dispensing label.

Co-amoxiclav Storage And Expiry Times

Once made up into oral suspension, co-amoxiclav needs to be refrigerated at 2°C – 8°C.

Once mixed with water, co-amoxiclav has an expiry time of 7 days.

Augmentin, a branded co-amoxiclav solution, has 7 days expiry time after the reconstitution.

Conclusion

I looked in this post at some essential information surrounding the use of amoxicillin in children.

Patients/parents are advised to:

  • Follow the GP’s instructions on the dosage of liquid amoxicillin
  • Cross-check the names of amoxicillin on the bottle with the name of the product/amoxicillin dispensed.
  • Store liquid amoxicillin according to label instructions
  • Familiarize themselves with the content of the product information leaflet
  • Store medicines away from children’s reach

 

References

Dar-Odeh, N.S., Abu-Hammad, O.A., Al-Omiri, M.K., Khraisat, A.S. and Shehabi, A.A., 2010. Antibiotic prescribing practices by dentists: a review. Therapeutics and clinical risk management, 6, p.301.Available at: https://bnf.nice.org.uk/ Accessed on 17/06/2020