High-dose Amoxicillin

The best dose of amoxicillin has changed in recent years.

High-dose amoxicillin is considered the most effective and safest of the first-line treatments, rather than switching to a broad spectrum antibiotic.

Dr. Greene’s Answer:

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 80 to 90 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.

References and Resources

Lieberthal AS, et al. The diagnosis and management of acute otitis media [published correction appears in Pediatrics. 2014 Feb;133(2):346. Dosage error in article text]. Pediatrics. 2013;131(3):e964-e999. doi:10.1542/peds.2012-3488

Venekamp RP, et al. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev. 2015;2015(6):CD000219. doi:10.1002/14651858.CD000219.pub4

Medical review by: Laura Webb, Alan Greene
Last medical review: February 02, 2023
Updated: February 6, 2023

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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20 Comments

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  1. Lucinda Lai

    My husband is on a high dosage of Amoxicillin 500 mg. Two in the morning, two at lunch and two at dinner. Now the doctor said that he doesn’t have a bacterial infection because my husband is still coughing, no fever or sinus trouble. The doctor said to complete the medication. That means another week of this. He’s been sick for 7 weeks now and his doctor said that he has a bad cold.

    Added:
    • Cheryl Greene

      Dear Lucinda,

      Dr. Greene discusses antibiotic use and overuse in this article. He suggestes you read it, print it, take it to your doctor.

      I hope that helps.
      Best, @MsGreene
      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

      Added:
  2. Rohit Kesharwani

    My 4 year old, weighing 35 pounds was suggested 657 mg of Amoxicillin 2 times a day i.e. total 1350 mg per day. He developed rashes all over the body in a week. Was he given overdose of Amoxicillin?

    Added:
  3. antonio ribeiro

    I’ve H. pylori, My Dr. prescribed 2000 mg of Amoxicilin daily plus 1000
    of Clarithromycin to much? I’m 75 years old.
    Thank you

    Added:
  4. john

    I have been prescribed 1625 for strep throat; so far it has done nothing. Was going to increase it to 2625 a day. Is that dangerous or just see how you react.

    Added:
  5. 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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  6. 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

    Added:
  7. 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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  8. 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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  9. Rachel white

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

    Added:
    • 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.

      Added:
  10. 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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  11. 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?

    Added:
    • 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.

      Added:
      • Pam

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

        Added:
    • 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.

      Added:
  12. 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.

    Added:
  13. 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.

    Added:
    • 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…

      Added:
  14. 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

    Added:

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