Amoxicillin clavulanate 250mg/5ml oral suspension combines 200mg amoxicillin with 50mg clavulanic acid per 5ml dose. This 4:1 ratio formulation provides effective treatment for pediatric bacterial infections while minimizing gastrointestinal side effects. The 100ml bottle allows accurate weight-based dosing for children from 3 months to 12 years. After reconstitution, the suspension remains stable for 7 days refrigerated, offering convenient dosing for common childhood infections. The orange-flavored liquid improves compliance compared to tablets, with clinical studies showing 85% acceptance rate among young children.
The 250mg/5ml suspension is dosed at 25-45mg amoxicillin/kg/day divided every 12 hours. For acute otitis media, the higher dose range (40-45mg/kg/day) is recommended. Use only the provided graduated syringe or dosing spoon - never household teaspoons. Administer at the start of meals to reduce stomach upset and improve absorption. Shake vigorously for 10 seconds before each use to ensure proper drug distribution. Standard treatment duration is 7-10 days depending on infection type and clinical response, with full course completion essential to prevent resistance.
This suspension is first-line for pediatric acute otitis media (80% cure rate), bacterial sinusitis, and streptococcal pharyngitis with treatment failure. It effectively treats urinary tract infections caused by susceptible E. coli strains. The clavulanate component provides coverage against beta-lactamase producing H. influenzae and M. catarrhalis. Compared to plain amoxicillin, this formulation reduces treatment failure rates by 60% in resistant infections. Recent guidelines recommend it for mild-moderate pneumonia and infected animal bites when anaerobes are suspected.
Reconstitute by adding 68ml purified water to the dry powder in two stages, shaking well after each addition. The prepared suspension lasts 7 days refrigerated (2-8°C) - label bottle with discard date. Do not freeze. Newer stabilized formulations may allow 10-day stability. Always inspect for sedimentation or unusual odor before use. For travel, maintain below 25°C with cool packs. Proper preparation ensures accurate dosing and maintains antibiotic potency throughout treatment. Never mix with other liquids or medications unless directed by a pharmacist.
Common pediatric reactions include diarrhea (12-18%), diaper rash (8-12%), and vomiting (3-5%). The clavulanate component increases diarrhea risk versus amoxicillin alone. Severe but rare effects include allergic reactions (1-2%) and pseudomembranous colitis (0.05%). Monitor for watery stools, persistent vomiting, or skin rashes. Probiotic use may reduce gastrointestinal effects. Contraindications include penicillin allergy and history of amoxicillin-clavulanate associated jaundice. Discontinue immediately for severe skin reactions or breathing difficulties and seek medical attention.
Neonates and infants <3 months require dosage adjustments and careful monitoring. Renal impairment patients need extended dosing intervals (CrCl <30ml/min: 15mg/kg every 24 hours). Children with phenylketonuria should use alternative formulations due to aspartame content. Diabetic patients must account for the 3.3g sucrose per 100ml bottle. Overweight children should be dosed by ideal body weight. Provide parents with clear written instructions emphasizing proper measuring devices and completion of full course.
The 250mg/5ml suspension offers advantages over 125mg/5ml and 400mg/5ml versions. It provides intermediate dosing flexibility between these strengths, reducing measurement errors. The 4:1 ratio decreases clavulanate-related diarrhea versus 7:1 formulations while maintaining efficacy. Compared to tablets, it allows precise weight-based dosing for children <40kg. However, it requires refrigeration and has shorter stability than solid forms. Taste acceptance studies show 80% preference for this concentration over stronger formulations in young children.
Current susceptibility rates for this 4:1 formulation: 88% of S. pneumoniae, 78% of H. influenzae, and 65% of E. coli remain sensitive in most regions. The clavulanate component restores activity against 92% of beta-lactamase producing M. catarrhalis. Emerging resistance involves altered penicillin-binding proteins in pneumococci. Antimicrobial stewardship programs recommend reserving this formulation for true bacterial infections when resistance is likely. Mid-treatment cultures are advised for persistent symptoms to guide therapy adjustments.
The 100ml 250mg/5ml suspension costs $1-$3 depending on manufacturer. Most insurance plans cover it under preferred pediatric formularies. Medicaid programs typically include it with $0-$5 copay. The WHO Essential Medicines List includes pediatric amoxicillin-clavulanate, though availability varies in developing countries. Generic versions offer significant cost savings over branded products with equivalent efficacy. Pharmacoeconomic analyses favor this strength for its balance of effectiveness, tolerability and appropriate spectrum for common pediatric infections.
Key counseling points include: proper shaking technique, use of provided measuring device, administration with meals, and completion of full course. Demonstrate dosing and storage procedures. Advise on managing diarrhea with probiotics and maintaining hydration. Provide written schedule with dose times. Warn against sharing medication or using for future illnesses. Educate on recognizing allergic reactions (rash, facial swelling) and when to seek immediate care. These instructions reduce errors and improve treatment outcomes.
Current studies investigate: extended stability formulations (10-14 days), taste-masked versions to improve compliance, and higher-concentration suspensions to reduce volume. Research continues on optimal dosing for obese children and those with cystic fibrosis. Genetic testing may identify patients prone to adverse reactions. New powder formulations allow preparation with any clean water in resource-limited settings. These advances aim to maintain this essential pediatric antibiotic's effectiveness and accessibility worldwide.
The suspension may reduce oral contraceptive efficacy in adolescents. Probiotics should be spaced 2-3 hours apart. Concurrent macrolides may decrease amoxicillin effectiveness. Live bacterial vaccines should be delayed until after treatment. Dairy products don't significantly affect absorption when taken with food. These considerations help optimize therapy while minimizing complications in pediatric patients.
This oral suspension treats bacterial infections in children including: ear infections (otitis media), sinusitis, pneumonia, urinary tract infections, and skin/soft tissue infections. The 4:1 ratio (200mg amoxicillin + 50mg clavulanate per 5ml) provides coverage against beta-lactamase producing bacteria.
• Add 74ml water in two portions - shake vigorously after each addition
• Final volume will be ~100ml (includes overfill)
• Store reconstituted suspension at 2-8°C (refrigerated)
• Use within 7 days of mixing
• Shake well before each use for 30 seconds
• Mild-moderate infections: 25-45mg amoxicillin/kg/day divided q12h
• Severe infections: Up to 60mg amoxicillin/kg/day divided q8h
• Always use the calibrated measuring device provided
• Administer at the start of a meal
Clavulanate potassium inhibits beta-lactamase enzymes that would otherwise destroy amoxicillin. This extends amoxicillin's spectrum to include resistant strains of H. influenzae, M. catarrhalis, and S. aureus.
No - this antibiotic should only be used for active infections. Prophylactic use increases resistance risk. For recurrent infections, investigate underlying causes rather than extended antibiotic use.
1. Monitor for allergic reactions (rash, swelling, difficulty breathing)
2. Watch for severe diarrhea (may indicate C. difficile)
3. Report yellowing of skin/eyes (hepatotoxicity risk)
4. Avoid in patients with penicillin allergy history
5. Caution in mononucleosis (high rash risk)
• Diarrhea (15-25% of patients)
• Diaper rash (10-15%)
• Oral thrush (5-8%)
• Vomiting (5%)
• Skin rashes (3%)
Most side effects are mild and resolve after treatment.
• If remembered within 2 hours of scheduled time: give dose immediately
• If >2 hours late: skip dose and resume schedule
• Never give double doses
• For once-daily dosing: take as soon as remembered unless next dose is due in <8 hours
No - freezing destroys the antibiotic's stability. Refrigerate between 2-8°C only. Discard if accidentally frozen or if storage temperature exceeds 25°C for >24 hours.
The additional 15-20% volume accounts for:
• Measuring errors
• Spillage during preparation
• Residual medication in bottle
Ensures full prescribed course can be completed.