Maximum Dosing for Amoxicillin and Amoxicillin-Clavulanate

Patient Population:
Pediatric

Although the absolute maximum Amoxicillin dose is 4000 mg/day, we recommend the following for usual maximum dosing when targeting a high dose (80-90 mg/kg/day): 

  • Amoxicillin suspension - usual maximum 2000 mg/day = 1000 mg/dose bid 
  • Amoxicillin tablet - usual maximum 875 mg/dose or 1000 mg/dose (2 of the 500mg tablets) 
  • Amoxicillin-clavulanate (Augmentin) suspension - usual maximum 2000 mg/day based on amoxicillin component. The recommended maximum dose of clavulanate component is 6.4 mg/kg/day. Different formulations are needed based on patient weight to keep within this recommended range.   
    • If patient weight < 40kg, use Augmentin-ES 600 mg/5ml formulation  
    • If patient weight >= 40kg, use regular Augmentin 400 mg/ml formulation 
  • Amoxicillin-clavulanate (Augmentin) tablet 
    • Usual maximum 875 mg amoxicillin/dose bid 
    • For acute bacterial sinusitis with high-risk features such as systemic illness, fever 39C or higher, or immunocompromised host, use maximum dose of 2000 mg amoxicillin/dose bid (2 of the 1000 mg XR tablets)