How much is the dosage for syrup Moxclav for 5-year-old, 18 kg child?
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Moxclav syrup pediatric dosage 5 year 18 kg amoxicillin clavulanate
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I now have solid data from multiple authoritative sources. Here is the full answer:
Moxclav (Amoxicillin-Clavulanate) Syrup - Dosage for a 5-year-old, 18 kg child
Moxclav is a brand name for amoxicillin + clavulanate (the same drug as Augmentin). Dosing is always calculated on the amoxicillin component by weight.
Standard Dose (most common infections - e.g., skin, soft tissue, UTI, mild pneumonia)
- 25-45 mg/kg/day of amoxicillin component, divided every 12 hours (BID)
- For 18 kg: 25 mg × 18 = 450 mg/day → 225 mg per dose, twice daily
- Or up to 45 mg/kg/day: 45 × 18 = 810 mg/day → ~405 mg per dose, BID
High Dose (AOM = acute otitis media, sinusitis, lower respiratory tract, suspected resistant pneumococcus)
- 80-90 mg/kg/day of amoxicillin, divided every 12 hours (BID) or every 8 hours (TID)
- For 18 kg: 90 × 18 = 1,620 mg/day → 810 mg per dose, BID (or ~540 mg per dose, TID)
Source: Rosen's Emergency Medicine; Goodman & Gilman's Pharmacology; SSM Health CPG
Volume to Give (by syrup formulation)
| Formulation | Amoxicillin per 5 mL | Standard dose (per dose) | High dose (per dose) |
|---|---|---|---|
| 125/31.25 mg per 5 mL | 125 mg/5 mL | ~9 mL per dose (BID) | Not practical |
| 200/28.5 mg per 5 mL | 200 mg/5 mL | ~5.5 mL per dose (BID) | ~20 mL per dose |
| 250/62.5 mg per 5 mL | 250 mg/5 mL | ~4.5 mL per dose (BID) | ~16 mL per dose |
| 400/57 mg per 5 mL | 400 mg/5 mL | ~2.8 mL per dose (BID) | ~10 mL per dose (BID) |
| 600/42.9 mg per 5 mL (ES) | 600 mg/5 mL | --- | ~6.75 mL per dose (BID) |
The most common pediatric formulation used in practice is 250/62.5 mg per 5 mL or 400/57 mg per 5 mL. Check the bottle label before calculating the volume.
Quick Calculation Example (most likely scenario - 400 mg/5 mL syrup, standard dose)
- Standard dose 45 mg/kg/day: 45 × 18 = 810 mg/day ÷ 2 doses = 405 mg per dose
- Volume: (405 ÷ 400) × 5 mL = ~5 mL (1 teaspoon) per dose, twice daily
Important Notes
- Always give at the start of a meal to reduce GI side effects and improve clavulanate absorption.
- Do not double the dose of clavulanate if you need more amoxicillin - this causes excess clavulanate and severe diarrhea.
- Keep clavulanate dose below 10 mg/kg/day to limit GI side effects.
- Typical course: 7-10 days depending on indication.
- For children under 40 kg (this child qualifies), never use the standard 250 mg adult tablet - it contains too much clavulanate for the amoxicillin amount.
Clinical note: The exact dose depends on the indication (mild vs. severe infection). Always confirm with the prescribing physician and check the specific Moxclav syrup formulation available in your region, as concentrations vary.
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