What is the recommended dosing for cefdinir (Omnicef) in the treatment of sinus infections?

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From the Guidelines

Cefdinir is recommended at a dosage of 7 mg/kg every 12 hours or 14 mg/kg once daily for children with sinus infections, up to the adult maximum dose, for 10 days, as an alternative to first-line treatments in cases of hypersensitivity to amoxicillin 1. The dosage of cefdinir for sinus infections is based on weight for children, with a typical dose range as mentioned, and should be taken with or without food, though taking it with food may help reduce stomach upset.

  • Key considerations for cefdinir use include:
    • Dosage adjustment for patients with kidney impairment, though specific guidance for this population is not provided in the context of the given evidence.
    • Potential for cross-reactivity in patients with penicillin allergies, though this is less common with third-generation cephalosporins like cefdinir.
    • Importance of completing the full course of antibiotics even if symptoms improve before finishing the prescription. It's crucial to note that cefdinir is not the first-line treatment for sinus infections but can be considered for children with hypersensitivity to amoxicillin, as outlined in the guideline on diagnosis and management of acute bacterial sinusitis in children 1.
  • The choice of antibiotic should always consider the most recent and highest quality evidence, as well as local resistance patterns and patient-specific factors. Given the provided evidence, cefdinir's role is more clearly defined in the context of pediatric patients with specific sensitivities rather than as a broadly recommended first-line treatment for all cases of sinus infections.

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. Acute Maxillary Sinusitis 7 mg/kg q12h or 14 mg/kg q24h 10 days 10 days

The recommended dosing for cefdinir (Omnicef) in the treatment of sinus infections is:

  • Pediatric patients: 7 mg/kg every 12 hours or 14 mg/kg every 24 hours for 10 days.
  • Maximum dose: 600 mg per day. 2

From the Research

Cefdinir Sinus Infection Dosing

The recommended dosing for cefdinir (Omnicef) in the treatment of sinus infections is as follows:

  • Adults and adolescents: 600 mg once daily or 300 mg twice daily for 10 days 3, 4
  • Pediatric patients: 14 mg/kg/day in one or two daily doses for 5 or 10 days 5

Efficacy of Cefdinir

Cefdinir has shown good clinical and bacteriological efficacy in the treatment of sinus infections, with cure rates of approximately 90% 3

  • Cefdinir is effective against common pathogens such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 3, 6, 7
  • Cefdinir has been shown to be as effective as other recommended regimens, including amoxicillin/clavulanate and levofloxacin, in the treatment of acute bacterial rhinosinusitis 7

Safety and Tolerability

Cefdinir is generally well tolerated, with mild diarrhea being the most common adverse event 3, 6, 4

  • Cefdinir has a low propensity to suppress the normal commensal flora 7
  • The oral suspension of cefdinir has been rated highly by children in terms of its taste and smell 7

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Efficacy and safety of cefdinir in the treatment of maxillary sinusitis.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2000

Research

The efficacy of cefdinir in acute bacterial rhinosinusitis.

Expert opinion on pharmacotherapy, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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