From the FDA Drug Label
The recommended dosage and duration of treatment for infections in pediatric patients are described in the following chart; the total daily dose for all infections is 14 mg/kg, up to a maximum dose of 600 mg per day. Pediatric Patients (Age 6 Months Through 12 Years) Type of Infection Dosage Duration Acute Bacterial Otitis Media 7 mg/kg q12hor 14 mg/kg q24h 5 to 10 days 10 days CEFDINIR FOR ORAL SUSPENSION PEDIATRIC DOSAGE CHART aPediatric patients who weigh ≥ 43 kg should receive the maximum daily dose of 600 mg.
For an 82-pound (approximately 37 kg) 12-year-old female with an ear infection, the recommended dose of cefdinir is 14 mg/kg per day, up to a maximum dose of 600 mg per day.
- The patient's weight is 37 kg, which is less than 43 kg, so the dose is calculated based on weight: 14 mg/kg = 14 mg/kg x 37 kg = 518 mg per day.
- The dose can be administered as 7 mg/kg q12h (every 12 hours) or 14 mg/kg q24h (every 24 hours).
- For this patient, the dose would be approximately 259 mg every 12 hours or 518 mg every 24 hours.
- Since the patient is close to the 43 kg threshold, the maximum daily dose of 600 mg should not be exceeded 1.
From the Research
For a 12-year-old female weighing 82 pounds (approximately 37 kg) with an ear infection, the recommended dose of cefdinir is 14 mg/kg/day divided into two doses, which equals approximately 260 mg twice daily, as supported by 2 and other studies. The typical duration of treatment is 5-10 days, with 10 days being common for otitis media (ear infections) 3. Cefdinir should be taken with or without food, though taking it with food may help reduce stomach upset. The medication comes as a suspension (125 mg/5 mL or 250 mg/5 mL) or as 300 mg capsules. For this patient, the 300 mg capsules would be slightly higher than the calculated dose but would likely be prescribed as one capsule every 12 hours. Some key points to consider when prescribing cefdinir include:
- Common side effects include diarrhea, nausea, and rash 4, 5.
- It's essential to complete the full course of antibiotics even if symptoms improve before finishing the medication.
- If the patient has a penicillin allergy, inform the healthcare provider as there is potential for cross-reactivity with cephalosporins like cefdinir. However, according to the most recent and highest quality study 6, amoxicillin-clavulanate should be the treatment of choice for children between 6 months and 12 years of age with AOM, as it was more effective in eradicating Streptococcus pneumoniae from the culture compared to cefdinir. Therefore, amoxicillin-clavulanate may be a better option for this patient, considering the potential benefits in terms of morbidity, mortality, and quality of life.