• Amoxicillin and co-amoxiclav are available as a variety of powders, oral suspensions, capsules, or tablets and are suitable for children 1 month of age or older.
• Amoxicillin should only be used if the pathogen is known to be sensitive to it, as there is a high rate of resistance to it in the community.
• Some experts recommend that a double-dose should be used, and this is recommended for the treatment of 'severe' infections by the British National Formulary [BNF for Children, 2007] (pyelonephritis may be considered to be a severe infection). However, this practice varies; if in doubt seek expert advice.
• Amoxicillin and co-amoxiclav should not be taken by children who have true penicillin allergy. However, gastrointestinal adverse effects alone (e.g. nausea, vomiting, or diarrhoea) do not constitute an allergy to penicillin.
• Consider using an alternative antibiotic to co-amoxiclav if the child has a history of hepatic impairment. The Commission on Human Medicines (formerly the Committee on the Safety of Medicines) has advised that cholestatic jaundice may rarely occur during or shortly after the use of co-amoxiclav [CSM, 1997]. However, this is more common in men, in people over the age of 65 years, and with longer courses of treatment (over 14 days), and so is unlikely to be problematic in children receiving co-amoxiclav for short periods.

[BNF 54, 2007]