Amoxicillin for kids: Safety, side effects, and other considerations

In this article:

• Amoxicillin for kids: Why it\'s prescribed
• Amoxicillin dosage for kids
• Amoxicillin dosage chart for kids
• What forms of amoxicillin are best for pediatric patients?
• Tips for taking amoxicillin
• Amoxicillin side effects in kids
• When not to give your child or infant amoxicillin

In this article

• Amoxicillin for kids: Why it\'s prescribed
• Amoxicillin dosage for kids
• Amoxicillin dosage chart for kids
• What forms of amoxicillin are best for pediatric patients?
• Tips for taking amoxicillin
• Amoxicillin side effects in kids
• When not to give your child or infant amoxicillin

Amoxicillin is a type of penicillin antibiotic used to treat various bacterial infections. It works by killing bacteria and stopping infection from spreading. Amoxicillin is approved by the Food and Drug Administration (FDA) to treat bacterial infections affecting the nose, ear, and throat, as well as lower respiratory tract infections, sinus infections, ulcers, and skin infections.

If your child has been prescribed amoxicillin, you may be wondering how safe it is. Amoxicillin is considered a first-line treatment option for many of the most common bacterial infections kids get, such as ear infections, strep throat, pneumonia, and sinus infections. It’s considered effective and safe, as well as inexpensive and widely available.

Here, we’ll break down everything you need to know about amoxicillin for kids, including why it’s prescribed, recommended dosage, side effects, drug interactions, and when amoxicillin may not be the best choice for your child.

Amoxicillin for kids: Why it’s prescribed

If you take your child to a healthcare professional and they are diagnosed with a bacterial infection, amoxicillin is often a first-line treatment option for common childhood ailments, including acute sinusitis, bacterial pharyngitis, and ear infections.

Andrew Youssouf, MD, an emergency medicine physician and medical director of Ikon Recovery, agrees that amoxicillin is a safe and effective antibiotic for children. It’s an antibiotic that many healthcare professionals will choose over other antibiotics. “Compared to other antibiotics, it has a favorable safety profile and is generally well-tolerated by kids,” Dr. Youssouf says. “Doctors often choose it for its effectiveness against common bacterial infections, making it a go-to option in pediatric care.”

That said, pediatricians are careful not to prescribe antibiotics when they are not warranted. First of all, antibiotics should only be used to treat bacterial infections. So, if your child has the common cold or another virus, antibiotics are not effective and should not be prescribed. There are indications, too, that many ear infections will resolve without antibiotics. That’s why many pediatricians wait two to three days before prescribing antibiotics like amoxicillin for an ear infection.

One main reason that healthcare professionals don’t want to over-prescribe antibiotics is because of a phenomenon called antibiotic resistance, which is when bacteria become resistant to specific antibiotics, and then those specific antibiotics no longer work. Other concerns in the pediatric population include the fact that taking antibiotics early in life may increase the risk of allergies or other conditions. For instance, a study from 2022 found that children who took antibiotics before the age of two were at increased risk of asthma, respiratory allergies, celiac disease, ADHD, obesity, and eczema.

That being said, when your child needs an antibiotic like amoxicillin, you should give your child the appropriate dose. Amoxicillin is used to treat infections like pneumonia, and it’s important to use the medication as prescribed by your child’s healthcare provider. Additionally, when bacterial infections aren’t treated with effective antibiotics, more serious conditions, like sepsis, can occur. Septis is when the immune system has an extreme—and sometimes life-threatening—reaction to an infection.

Amoxicillin dosage for kids

“Amoxicillin dosage for kids is typically based on two main factors,” says Raj Dasgupta, MD, a quadruple board-certified physician specializing in internal medicine, pulmonology, critical care, and sleep medicine. These two factors are the child’s weight and how severe their infection is.

“Doctors also take into account how bad the infection is, where the infection is located, and the patient’s medical history, including their kidney function,” Dr. Dasgupta says. “The goal is to give enough to knock out the infection but not too much to cause unnecessary side effects.”

“It’s common for a child’s doctor to focus on the specific type of illness a child has when figuring out their amoxicillin dosage,” says Uzma N. Hasan, MD, division chief of pediatric infectious diseases at RWJBarnabas Health. She says she may prescribe higher doses for treating ear infections and pneumonia and lower doses for treating any other infection.

The following chart helps give you an idea of how amoxicillin dosing works for kids based on their infection type and severity. Remember that these are averages, and healthcare providers change dosages based on multiple patient factors, including age, weight, and other medical conditions.

What forms of amoxicillin are best for pediatric patients?

There are two main forms of amoxicillin prescribed to kids: liquid formulations and amoxicillin capsules or tablets. Both types of formulations are equally effective, but liquid formulation is preferred when kids are younger because it is easier for them to swallow. Most children like the taste of the liquid formulation and take it willingly.

On the other hand, older kids may be able to take amoxicillin in tablet form. “Older kids might take chewable tablets or capsules if they’re able to swallow them without any issues,” Dr. Dasgupta says. Your pediatrician can help you determine the best form of amoxicillin for your child based on their age and developmental maturity.

Tips for taking amoxicillin

Even when you are giving your child an easy-to-swallow form of amoxicillin, like liquid amoxicillin, it can be challenging. The American Academy of Pediatrics (AAP) offers the following tips:

• Never force your child to take a medication, as that can cause choking or vomiting
• Use a medication syringe or a dropper; don’t use a spoon
• Always give medication to your child while they are sitting up
• If using a syringe, place it past the child’s gum line so it gets deposited into their mouth
• Aim for the back of the child’s tongue or cheek, not the back of the throat
• Consider letting your child hold the syringe if that helps them feel more comfortable
• If necessary, get the help of another adult to gently hold your child in place while giving them the medication
• If you need further assistance, reach out to your pediatrician for tips

Amoxicillin side effects in kids 

One of the reasons that amoxicillin is so often prescribed for kids is that it is well tolerated, effective, and has less serious side effects than other antibiotics. “It’s often the go-to because it works well for commonly encountered infections in children and usually doesn’t cause serious side effects,” Dr. Dasgupta says.

Not every child will experience side effects from amoxicillin, but minor side effects are common. Many of these side effects are gastrointestinal and include nausea, diarrhea, stomachaches, and stomach cramps. “This is not unusual. Most antibiotics cause loose stool or diarrhea,” Dr. Hasan explains, adding that mild rashes and some joint swelling are also possible.

While amoxicillin side effects are usually mild, and amoxicillin is overall a safe medication, Dr. Youssouf says that it’s important to watch for signs of allergic reactions. “It is essential to differentiate between common side effects and allergic reactions, which can be more serious,” he says.

Signs of a significant allergic reaction to amoxicillin include:

• Trouble breathing
• Swelling of the face or throat
• Hives

“If you suspect your child has an allergic reaction, seek medical help immediately,” Dr. Youssouf emphasizes.

When not to give your child or infant amoxicillin

There are certain children who should not take amoxicillin, including:

• Children who are allergic to amoxicillin, penicillin, or cephalosporin antibiotics
• Children who are allergic to any ingredients in amoxicillin liquid, tablets, capsules, or chewable tablets
• Children who are infected with mononucleosis
• Children with a history of kidney disease or liver disease

You should never give your child amoxicillin or any antibiotic unless they have a bacterial infection, as confirmed by their pediatrician. Young children get numerous colds, coughs, and sore throats, and most of these are caused by viruses. Even ear infections don’t always need antibiotics. Your pediatrician will be able to tell whether your child needs antibiotics and will prescribe them accordingly.