How much amoxicillin should I give my child?

In this article:

• Amoxicillin pediatric dosing
• Amoxicillin dosage 
• Amoxicillin administration in children
• Common side effects of amoxicillin in children
• The bottom line

In this article

• Amoxicillin pediatric dosing
• Amoxicillin dosage 
• Amoxicillin administration in children
• Common side effects of amoxicillin in children
• The bottom line

Amoxicillin is a widely prescribed antibiotic from the penicillin class of drugs. According to the Centers for Disease Control and Prevention (CDC), it is among the two most commonly prescribed antibiotics for bacterial infections. Amoxicillin, also referred to by the brand name Amoxil, is often prescribed for bacterial infections, including community-acquired pneumonia, bronchitis, sinusitis, and infections of the ears (such as acute otitis media), nose, throat (such as strep throat or tonsillitis), and skin. It can also be prescribed for urinary tract infections (UTI). The appropriate dose for children varies based on age, weight, and type and severity of infection. Continue reading to learn more about dosing amoxicillin for children.

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Amoxicillin pediatric dosing

Amoxicillin is available in various formulations tailored to meet the needs and preferences of different ages. These formulations, all approved by the U.S. Food and Drug Administration (FDA), include:

• Oral capsules
• Oral tablets
• Oral extended-release tablets
• Oral chewable tablets
• Oral suspension (liquid)

Babies, toddlers, and young children are often prescribed the liquid form of amoxicillin. Chewable tablets may be used for children who can chew without choking. Older children and adolescents who can swallow pills may be prescribed capsules or tablets, though many still prefer the liquid or chewable form. The healthcare provider will determine the best formulation based on the child’s needs, with input from both the parent and the child (if they are old enough to express a preference). 

A healthcare provider will determine the dose of amoxicillin based on individual factors, including age, weight, and the type and severity of infection. Note that amoxicillin does not treat viral infections such as the common cold or flu. 

Amoxicillin dosage 

The following are general dosing guidelines. Your child’s healthcare provider will determine the exact dosage based on individual factors, so follow their specific recommendations.

Dosage for pediatric patients younger than 12 weeks

For children younger than 12 weeks (3 months), healthcare providers generally prescribe amoxicillin for at least 10 days if Streptococcus pyogenes cause the infection to prevent complications such as rheumatic fever. The dose is based on the child’s weight, typically 30 milligrams (mg) per kilogram (kg) of body weight per day, divided into two doses, with one dose given every 12 hours. The child must complete the entire course of treatment, even if they start to feel better, before finishing the medication.

Dosage for adults and pediatric patients 12 weeks and older

For adults and children 12 weeks and older, healthcare providers usually prescribe amoxicillin for at least 10 days if Streptococcus pyogenes cause the infection to prevent complications like rheumatic fever. The child needs to complete the full course of treatment, even if they start feeling better before the medication is finished. In some cases, the infection may require treatment for several weeks, and follow-up might be required for several months to ensure the infection is completely resolved.

Amoxicillin dosing for this age group follows. 

Ear/nose/throat, skin/skin structure, or genitourinary tract infections:

• Mild/moderate:
  • Ages 3 months and older and weighing more than 40 kg (88 lbs): 500 mg every 12 hours, or 250 mg every 8 hours
  • Ages 3 months and older and weighing less than 40 kg: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours
• Severe infections:
  • Ages 3 months and older and weighing more than 40 kg: 875 mg every 12 hours or 500 mg every 8 hours
  • Ages 3 months and older and weighing less than 40 kg: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours

Lower respiratory tract infections:

• Mild/moderate or severe infections:
  • Ages 3 months and older and weighing more than 40 kg: 875 mg every 12 hours or 500 mg every 8 hours
  • Ages 3 months and older and weighing less than 40 kg: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours

Amoxicillin administration in children

Regardless of the dosage form, your child needs to complete the full course of amoxicillin, even if they start to feel better quickly. Finishing the medicine ensures that it works effectively to treat the infection. Doing so also helps prevent the bacteria from becoming resistant to the drug, which could make the antibiotic less effective in the future. 

Amoxicillin can be taken with or without food. If your child experiences stomach discomfort, taking it with food may help alleviate these side effects. 

If your child vomits or spits out the medicine, call your healthcare provider for medical advice.

If your child is prescribed oral liquid (suspension), ask your pharmacist how you should store it. You may need to store it in the refrigerator. Shake the bottle well (with the cap tightly closed) before measuring a dose. Measure the dose with a medicine measuring device. Do not use kitchen or household measuring devices, as they are not as accurate and could cause you to give a high dose or too little medicine. Your pharmacist will tell you when the liquid will expire, usually 14 days after it is mixed. Dispose of any unused medicine after it expires. If you are unsure if your child needs to continue treatment, consult the healthcare provider. 

If your child is prescribed chewable tablets, be sure they chew the tablet thoroughly before swallowing it. 

If your child resists taking their medicine, avoid calling it candy. This can lead to accidental overdose because the child might mistake the medicine for a treat and take too much. Instead, explain that the medicine is important for helping them get better and must be taken with the help of a parent or caregiver. You can also ask your pharmacist if the specific formulation can be flavored—this usually means flavoring the contents of the entire bottle—or if the medicine can be mixed with another liquid or soft food at each dose to improve the taste.

Contact your child’s healthcare provider if their symptoms worsen or do not improve after a few days or if you have concerns about their condition. 

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Common side effects of amoxicillin in children

Amoxicillin can cause side effects like nausea, vomiting, diarrhea, and rash. If your child develops a rash, it might be an allergic reaction, and you should contact your child’s healthcare provider immediately. Other signs of an allergic reaction may include hives, difficulty breathing or swallowing, or swelling of the face, lips, tongue, or throat. If your child has swelling or trouble breathing, call 911 and go to the emergency room.

Serious skin reactions are rare but require emergency medical attention. Look for symptoms like fever, sore throat, burning eyes, skin pain, rash, blistering, and peeling skin.

Diarrhea is a common side effect and usually resolves after the medication ends. However, if your child has watery or bloody stools, with or without stomach cramps and fever, even several months after stopping the antibiotic, contact your child’s healthcare provider.

If your child experiences mild side effects that are bothersome or do not go away, consult your child’s healthcare provider for advice.

The bottom line

Amoxicillin is an effective antibiotic for treating certain types of children’s bacterial infections. It is available in several formulations, with liquid and chewable tablets being the most common for younger patients. Your child’s healthcare provider determines the exact dose and depends on factors such as age, weight, and the type of infection. Your child needs to complete the full course of amoxicillin as prescribed, even if they start to feel better before finishing the medication. Always consult your healthcare provider if your child’s symptoms worsen or do not improve or if you have any other concerns.