Amoxicillin: A Guide for Parents and Caregivers

If you’re a parent, chances are you’ve heard of amoxicillin. It’s used very frequently for a variety of illnesses… At one point last year I had 6 different bottles of amoxicillin in my fridge for 3 different kids who were all sick with different things at the same time. 

A powerhouse in the pediatric medicine world, amoxicillin is a commonly prescribed antibiotic used to treat various bacterial infections. You may be wondering why amoxicillin is needed, how to give it, or what side effects to watch out for. This guide will provide you with essential information and practical tips.

What is Amoxicillin?

A member of the penicillin drug class, amoxicillin is an antibiotic that works by stopping the growth of bacteria that cause infections. Amoxicillin is an oldie but a goodie. While not the most powerful or broad antibiotic on the block, it’s great at treating lots of common bacterial illnesses that we see in children, such as: 

• Ear infections
• Strep throat
• Pneumonia
• Sinus infections
• Skin infections
• Urinary tract infections

Another bonus of amoxicillin is that it tastes OK and is usually well received by kids. Anyone who’s tried to give yucky-tasting medicine to a toddler can attest to the fact that yummy medicine is key. Making your child drink gross medicine is similar to wrestling an angry alligator. 

What is the Right Dose of Amoxicillin for My Child?

The dosage of amoxicillin for children is based on their weight and the type of infection being treated. Always follow the instructions on your label, and don’t be afraid to ask questions!

Amoxicillin comes in many different formulations—tablets, capsules, and various strengths of liquid. Kids are usually prescribed liquid, which is helpful for administration but can cause confusion with giving the right amount.

It is easy to mix up the directions, as they typically include a milligram (mg) dose and a milliliter (mL) volume. So, please ask questions at the doctor’s office and the pharmacy to be sure you understand your child’s dose and how to give it!

Pediatric dose errors are some of the more common medication mistakes, so don’t be shy. I like to recommend to my friends and patients that they demonstrate how much liquid to measure up with the pharmacist so that they’re comfortable when they get home. 

How Do I Give Amoxicillin?

Fortunately, amoxicillin is one of the better-tasting liquid medicines, so kids don’t usually put up too much of a fight. Pro tip: some pharmacies can even flavor it for you if your child is not a fan of the typical bubblegum-esque suspension. Keep the following tips in mind when giving the medicine: 

• Shake the liquid well before each use.
• Refrigeration is not required but is preferred, and it may taste better cold. 
• Use the measuring device provided with the medication.
• It can be given with or without food. 
• You can mix the liquid with a small amount of milk or juice if needed. 
  • Use caution with this. If your child doesn’t finish the milk or juice, you’ll have no idea how much of a dose they got. 
  • It’s important that your child gets the full dose each time.
• Give the medication at evenly spaced times throughout the day. 
  • For example, for a twice-a-day dose regimen, aim for something like 7 AM and 7 PM. 
  • It’s OK to be off by an hour or so to accommodate sleep. For example, 8 AM and 6 PM would be acceptable. 
• Older kids can just drink the medicine out of the measuring device or small cup. 
• For babies or any kids not able to sip reliably, use an oral syringe and squirt the medicine into the inside of the back of the cheek. 
  • You may have to do this in small increments so as not to overload your child’s mouth with too much liquid and make them gag or choke!  

I have fond memories of dancing around my kitchen when my oldest was 4 months old, squirting amoxicillin into the back of her inner cheek in teeny tiny increments, and singing to her to distract her between sips. She was probably thinking, “My mother is crazy.” 

How Often and How Long is Amoxicillin Given?

This depends on the type of infection being treated and the severity. Amoxicillin is usually given 2 or 3 times per day for several days; often 7-10 days total.

I know this can be frustrating and hard to remember, but it's important to complete the entire course of antibiotics, even if your child starts feeling better before it's finished.

This helps prevent the infection from returning and reduces the risk of antibiotic resistance. Amoxicillin liquid expires 14 days after it’s dispensed, so promptly throw away any unused medication at the end of your treatment course.

What are the Side Effects of Amoxicillin?

The good news is that amoxicillin is generally safe. Most kids handle it with no major issues, but here are some things to look out for: 

• Diarrhea
• Nausea or vomiting
• Rash

Most of these side effects are mild and resolve on their own. However, contact your child's doctor if these symptoms persist or worsen. I recommend always calling your doctor about a rash. Sometimes a rash is a normal side effect, but sometimes it can be a sign of an allergy, so it’s best to get professional advice if that occurs.

For preventing diarrhea, you can consider giving a probiotic medicine or something with active probiotic cultures (like yogurt) to your youngster to help regulate their GI tract. This is usually safe to do on your own, but ask your pediatrician first if your child is a baby or has any health concerns. 

Rarely, amoxicillin can cause more serious side effects. Seek immediate medical attention if your child experiences:

• Severe skin rash or hives
• Difficulty breathing 
• Swelling of the face, lips, tongue, or throat
• Severe diarrhea with blood in the stool

If your child has had an allergic reaction to penicillin or other antibiotics in the past, it's crucial to inform the doctor before starting amoxicillin. Also, be sure to let the doctor know about any serious medical conditions your child has so they can screen for drug interactions and an appropriate dose (for example, children with kidney problems may need a lower dose). 

What if I Miss a Dose of Medication? 

If you miss a dose of medication, give it as soon as you remember. If it’s close to the time of the next dose, skip the missed dose and continue on your regular dosing schedule. Don’t double up on a dose if you miss one. I usually set an alarm on my phone because this is an easy thing to forget in a busy household with young kids.

In summary, amoxicillin is a useful antibiotic that is given as a first-line choice for many common pediatric infections. It will only work for certain types of bacterial infections, not viruses.

Unfortunately, amoxicillin is no help with the flu or the common cold. If your child is prescribed amoxicillin for an ear infection, strep throat, or something else, you can expect them to feel better within 2 days of starting the medication. If their symptoms worsen or do not get better, reach out to your doctor! 

The following reference was used to compile this information:

U.S. National Library of Medicine. (n.d.). AMOXICILLIN powder, for suspension. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a91d9ff1-57dc-4569-9d0d-3d1b6ded9773

This article has been reviewed by Andrea Morrissey, PharmD, Board Certified Pediatric Pharmacy Specialist, and Chief Content Officer of Kids Med Guide. The content is for educational and entertainment purposes only and does not replace professional medical advice. Always consult your healthcare provider for medical guidance, and call 911 in an emergency.

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