Cefdinir 14 mg/kg/day Concentration
For a dose of 14 mg/kg/day, use either the 125 mg/5 mL or 250 mg/5 mL oral suspension concentration, depending on the child's weight and dosing frequency. Both concentrations deliver the same total daily dose when dosed appropriately 1.
Dosing Options for 14 mg/kg/day
The FDA-approved cefdinir dosing allows two equivalent regimens 1:
- Once-daily dosing: 14 mg/kg given every 24 hours
- Twice-daily dosing: 7 mg/kg given every 12 hours
Both regimens achieve the same total daily dose of 14 mg/kg/day and are clinically equivalent for most indications 1, 2.
Available Concentrations
125 mg/5 mL suspension:
- Used for lighter children or when larger volumes are acceptable
- Requires larger volume per dose but may be easier to measure precisely for smaller children
250 mg/5 mL suspension:
- Used for heavier children to reduce volume per dose
- More concentrated, requiring half the volume of the 125 mg/5 mL preparation
- Bioequivalent to the 125 mg/5 mL strength 1
Weight-Based Dosing Examples
For a child weighing 18 kg (40 lbs) receiving 14 mg/kg/day 1:
Once-daily option:
- 125 mg/5 mL: Give 10 mL every 24 hours
- 250 mg/5 mL: Give 5 mL every 24 hours
Twice-daily option:
- 125 mg/5 mL: Give 5 mL every 12 hours
- 250 mg/5 mL: Give 2.5 mL every 12 hours
Clinical Context
The 14 mg/kg/day dose is recommended as an alternative treatment for acute otitis media in penicillin-allergic children 2 and for various respiratory tract infections 3. Once-daily dosing has been studied for 10 days and shown to be as effective as twice-daily dosing for most infections, except skin infections where twice-daily dosing should be used 1.
Important Caveat
While 14 mg/kg/day is FDA-approved, this dose may be insufficient for penicillin-nonsusceptible Streptococcus pneumoniae. Pharmacodynamic studies show that even a 25 mg/kg/day dose fails to achieve adequate time above MIC (<40% of dosing interval) for resistant strains 4. For infections likely caused by resistant pneumococci, high-dose amoxicillin-clavulanate (90 mg/kg/day) is preferred 2.