Azithromycin 40mg/ml
Azithromycin 40mg/ml. How much should be the dose for 15 kg boy per day in ml once daily
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azithromycin pediatric dose mg/kg/day oral suspension community acquired pneumonia
Here is the complete dosing answer:
Azithromycin 40 mg/ml - Dose for a 15 kg Child
Step-by-step calculation
| Parameter | Value |
|---|---|
| Child's weight | 15 kg |
| Standard dose | 10 mg/kg/day (Day 1 loading dose) |
| Dose in mg | 15 kg × 10 mg/kg = 150 mg |
| Suspension concentration | 40 mg/ml |
| Volume to give | 150 mg ÷ 40 mg/ml = 3.75 ml |
Day 1: 3.75 ml once daily
Indication-based dosing (5-day regimen - most common)
This is the standard regimen for community-acquired pneumonia, otitis media, and sinusitis per the FDA prescribing information and UC Davis Pediatric CAP guidelines:
| Day | Dose (mg/kg) | Dose for 15 kg (mg) | Volume (40 mg/ml) |
|---|---|---|---|
| Day 1 | 10 mg/kg | 150 mg | 3.75 ml |
| Days 2-5 | 5 mg/kg | 75 mg | 1.875 ml (~1.9 ml) |
For pharyngitis/tonsillitis (5-day regimen):
- 12 mg/kg/day × 15 kg = 180 mg/day = 4.5 ml once daily for 5 days (max 500 mg/day)
For sinusitis (3-day regimen):
- 10 mg/kg/day × 15 kg = 150 mg/day = 3.75 ml once daily for 3 days
Key notes
- The textbook source (Rosen's Emergency Medicine) confirms: "azithromycin is given at 10 mg/kg for an initial dose, followed by 5 mg/kg for days 2 through 5"
- Maximum single dose: 500 mg (not a concern at 15 kg)
- Can be given with or without food
- Approved for children ≥6 months of age
For a once-daily dose for a 15 kg boy: 3.75 ml on Day 1, then 1.875 ml (≈1.9 ml) on Days 2-5 for standard infections.
For 12.5 kg child?
Azithromycin 40 mg/ml - Dose for a 12.5 kg Child
Step-by-step calculation
| Parameter | Value |
|---|---|
| Child's weight | 12.5 kg |
| Standard dose | 10 mg/kg/day (Day 1) |
| Dose in mg | 12.5 kg × 10 mg/kg = 125 mg |
| Suspension concentration | 40 mg/ml |
| Volume to give | 125 mg ÷ 40 mg/ml = 3.125 ml |
5-Day Regimen (CAP, Otitis Media, Sinusitis)
| Day | Dose (mg/kg) | Dose for 12.5 kg (mg) | Volume (40 mg/ml) |
|---|---|---|---|
| Day 1 | 10 mg/kg | 125 mg | 3.125 ml (~3.1 ml) |
| Days 2-5 | 5 mg/kg | 62.5 mg | 1.56 ml (~1.6 ml) |
By Indication
| Indication | Regimen | Daily Dose | Volume |
|---|---|---|---|
| CAP / Otitis Media | Day 1 loading | 125 mg | 3.1 ml |
| CAP / Otitis Media | Days 2-5 | 62.5 mg | 1.6 ml |
| Sinusitis | 10 mg/kg × 3 days | 125 mg | 3.1 ml |
| Pharyngitis/Tonsillitis | 12 mg/kg × 5 days | 150 mg | 3.75 ml |
Quick Summary
3.1 ml on Day 1, then 1.6 ml on Days 2-5 once daily (for CAP/otitis media). For pharyngitis: 3.75 ml once daily for 5 days.
- In practice, 3.1 ml is often rounded to 3 ml for ease of administration - confirm with the prescriber.
- Well within the maximum dose of 500 mg/day.
Indication of Azithromycin
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Indications of Azithromycin
Azithromycin is a macrolide antibiotic with a broad spectrum covering gram-positive, gram-negative, and atypical organisms. It is unique for its once-daily dosing and short treatment courses due to excellent tissue penetration and a long half-life of ~3 days. - Katzung's Basic & Clinical Pharmacology, 16e
1. Respiratory Tract Infections
| Infection | Notes |
|---|---|
| Community-acquired pneumonia (CAP) | First-line for atypicals; used alone or with beta-lactam |
| Acute otitis media | Pediatric use; 5-day or 3-day course |
| Acute bacterial sinusitis | 3-day or 5-day course |
| Pharyngitis/Tonsillitis | Alternative to penicillin (12 mg/kg/day x 5 days in children) |
| Whooping cough (Pertussis) | Drug of choice for treatment and post-exposure prophylaxis |
| COPD exacerbations | Active against H. influenzae |
| Atypical pneumonia | Mycoplasma, Chlamydophila, Legionella |
2. Sexually Transmitted Infections (STIs)
| Infection | Notes |
|---|---|
| Chlamydial urethritis/cervicitis | Single 1 g dose (alternative to doxycycline 7-day course) |
| Chancroid | Single 1 g dose |
| Gonorrhea | Combination regimens (with ceftriaxone) |
| Lymphogranuloma venereum (LGV) | Alternative agent |
3. Gastrointestinal Infections
| Infection | Notes |
|---|---|
| Traveler's diarrhea | Single 1000 mg dose; drug of choice |
| Campylobacter gastroenteritis | 500 mg once daily x 3 days; preferred regimen |
| Cholera | Pediatric first-line alternative |
4. Skin & Soft Tissue Infections
- Mild uncomplicated skin infections caused by Staphylococcus aureus and Streptococcus pyogenes
5. Mycobacterial Infections
| Infection | Notes |
|---|---|
| MAC (Mycobacterium avium complex) | Treatment and prophylaxis in HIV patients |
| Non-tuberculous mycobacteria (NTM) | Used in combination regimens |
6. Other Indications
| Indication | Notes |
|---|---|
| Toxoplasmosis | Active against T. gondii |
| Babesiosis | Combined with atovaquone (preferred therapy) |
| Endocarditis prophylaxis | 500 mg PO for dental procedures in penicillin-allergic patients (15 mg/kg in children) |
| Trachoma | Chlamydia trachomatis ocular infection; single dose |
| Typhoid fever | Alternative agent |
| Lyme disease | Alternative in penicillin allergy |
Organisms Covered
| Type | Examples |
|---|---|
| Gram-positive | S. pneumoniae, S. pyogenes, S. aureus (MSSA) |
| Gram-negative | H. influenzae, M. catarrhalis, Campylobacter, Salmonella |
| Atypicals | Mycoplasma, Chlamydia, Legionella, Bordetella |
| Mycobacteria | M. avium complex |
| Parasites | T. gondii, Babesia |
Key Pharmacological Advantages
- Once-daily dosing - long tissue half-life (~3 days)
- Short courses - often 3-5 days only
- Fewer drug interactions - does not inhibit CYP450 (unlike erythromycin/clarithromycin)
- Well tolerated - less GI side effects than erythromycin
Caution: Azithromycin prolongs the QT interval and may increase the risk of cardiac arrhythmias (torsades de pointes). Avoid in patients with known QT prolongation or on other QT-prolonging drugs.
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