High-dose Amoxicillin

My 26-month-old, 26-pound daughter was diagnosed as having an ear infection. Her doctor put her on amoxicillin–500 mg, twice a day. Everyone is telling me that 1000 mg per day is an awful lot. What do you think?

High-dose Amoxicillin

Dr. Greene’s Answer:

The best dose of amoxicillin has changed in recent years. The change to high-dose amoxicillin came because many bacteria were getting partially resistant to it. Rather than switching to antibiotics that are broader spectrum or with more side effects, high-dose amoxicillin is considered the most effective and safest of the first line treatments.

The recommended dosage used to be 10 to 30 mg per kg of body weight per day. But for ear infections, it is now better to give 60 to 80 mg per kg per day. For her, that would be somewhere between 750 and 1000 mg daily. The timing between doses does not need to be precise, but the farther apart the doses are, the lower the chances of diarrhea as a side effect.

Generally speaking, amoxicillin is a very safe and well tolerated medication, even at the higher doses. However, antibiotics do kill beneficial bacteria as well, and the more effective the antibiotic, the more likely this will happen. Eating yogurt with active cultures is a great way to replenish them. Some of the frozen varieties are the most effective.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Kisha

    My baby was 5 months old 16lbs prescribed 400mg twice a day on Friday by Monday she was hospitalized for uncontrollable seizures and has been seizing since and she is now 3 yrs old. I was told 800mg a day was to much for a baby who had a bad cold or “touch of pneumonia” she was born perfectly healthy with no health problems until I gave her amoxicillin. Was that too much for her?

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  2. emma

    My grand child who is 25 pounds and 18 months old was prescribed 7ml 400 mg amoxicillin two times a day. Was wondering isn’t this too much for the little one? She was a resident doctor and told he has a slight ear infection.
    Thanks

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  3. Nancy

    My mom is 98 years old, just left hospital had pneumonia and a UTI. I’m concerned over the antibiotic amox-clav250-62mg/5. 10-ML oral every 12 hrs. Mom is very susceptible to C-Diff. She has had 2 doses and already had diarrhea, should I lower dosage? Help?

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  4. Athena Havredakis

    I have an ear infection and my ENT doctor priscribed 2,000 Augmentin in the morning and 2,000 later in the day, is that too much? i am worried.

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  5. Rachel white

    Is 750mg of antibiotics amoxicillin to much for my partners tooth ache he is 35 and about 12 stone?

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    • Vicky

      My 14 year old son (weighs 7 stone) was prescribed 500mg Amoxicillin tablets to take 3 times a day adding up to 1500mg a day for a minor ear infection so I think your husbands dosage Sounds either just right or under what I would think he should have.

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  6. kinski

    I find amoxilin outdated drug, because so cheap and so many times prescribed not working well.

    I feel always horrible when take it. Recently I take Kalacid MR feel better and I have the feeling it fights better at only 500mg a day.

    Not sure why doctors prescribe old drugs, are those cheaper or lack of knowledge?

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  7. Manuel

    After my test, my doctor told me that I have H Pylori. He advised me to take 500 mg amoxil 2 – 2… Two 500 mg in the morning… And two 500 mg in the evening. A total of 2000 mg every day. I feel so restless. Isn’t this too much?

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    • Pam

      Yep it’s a lot. I have same dose. I felt like I was gonna die the first few days. Here the key… EAT A HEAVY MEAL morning n evening when u take this crazy pill-combo (skip lunch if u want). Trust me, u don’t want h-p lingering in your system. So yeah it’s a lot but HIT IT HARD. Then take the “natural remedies/supplements for h-p” when your done with the antibiotic.

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      • Pam

        Take the triple-combo of antibiotics for h-p!
        Don’t let it linger.

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    • Pam

      Yep it’s a lot. I have same dose. I felt like I was gonna die the first few days. Here the key… EAT A HEAVY MEAL morning n evening when u take this crazy pill-combo (skip lunch if u want). Trust me, u don’t want h-p lingering in your system. So yeah it’s a lot but HIT IT HARD. Then take the “natural remedies/supplements for h-p” when your done with the antibiotic.

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  8. Eric

    I’m taking amoxicillin for tooth abscess. The pain is almost unbearable so I took 1 thousand mg of it in an hour. I want to know if that will stop the pain and if not is it okay to take some ibuprofen.

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  9. CJ

    My ear nose and throat doctor told me that ear infections are usually a sign of dairy allergy or intolerance. After three years in a row with ear infections for my toddler and myself, I found this doctor, quit dairy and neither of us have had another ear infection.

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    • AN

      Hi,
      I’ve found your information interesting as I’ve read recently that ear infections in children are often caused by second hand smoke. It makes sense to me now remembering how my little boy’s father used to smoke around him those many years ago and I used to wonder why those frequent ear infections. But it could be dairy too, never heard of it though…

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  10. Sailu

    Hi
    Please include my email in u r list . I got answers for couple of questions regarding antibiotics for kids . Great job Doctor Greene

    Thanks
    Sailu

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