Recommended Dosage of Omnicef (Cefdinir) for Children
The recommended dosage of Omnicef (cefdinir) for children is 14 mg/kg/day, divided either as 7 mg/kg twice daily or as a single 14 mg/kg daily dose, with a maximum of 600 mg per day. 1
Dosing Guidelines Based on Age and Infection Type
Standard Pediatric Dosing
- Total daily dose: 14 mg/kg/day
- Maximum daily dose: 600 mg
- Administration options:
- Once-daily: 14 mg/kg once daily
- Twice-daily: 7 mg/kg every 12 hours
Duration by Infection Type
- Acute Bacterial Otitis Media: 5-10 days (twice daily) or 10 days (once daily)
- Acute Maxillary Sinusitis: 10 days
- Pharyngitis/Tonsillitis: 5-10 days (twice daily) or 10 days (once daily)
- Uncomplicated Skin Infections: 10 days (must be given twice daily) 1
Practical Weight-Based Dosing Chart
| Weight | 125 mg/5 mL formulation | 250 mg/5 mL formulation |
|---|---|---|
| 9 kg/20 lbs | 2.5 mL q12h or 5 mL q24h | Use 125 mg/5 mL product |
| 18 kg/40 lbs | 5 mL q12h or 10 mL q24h | 2.5 mL q12h or 5 mL q24h |
| 27 kg/60 lbs | 7.5 mL q12h or 15 mL q24h | 3.75 mL q12h or 7.5 mL q24h |
| 36 kg/80 lbs | 10 mL q12h or 20 mL q24h | 5 mL q12h or 10 mL q24h |
| ≥43 kg/95 lbs | 12 mL q12h or 24 mL q24h | 6 mL q12h or 12 mL q24h |
Special Considerations
Renal Impairment
- For pediatric patients with creatinine clearance <30 mL/min/1.73 m², reduce dose to 7 mg/kg once daily (maximum 300 mg) 1
Hemodialysis
- For children on hemodialysis: 7 mg/kg every other day with an additional dose after each dialysis session 1
Administration
- Can be given without regard to meals
- Suspension should be shaken well before each use
- After reconstitution, suspension is stable for 10 days at room temperature 1
Clinical Efficacy and Spectrum
Cefdinir is an oral third-generation cephalosporin with excellent activity against common pediatric respiratory pathogens including:
- Haemophilus influenzae (including β-lactamase producing strains)
- Moraxella catarrhalis
- Streptococcus pneumoniae (penicillin-susceptible strains)
- Streptococcus pyogenes 2
Important Considerations
- Once-daily dosing has not been studied for skin infections, so twice-daily dosing must be used for these infections 1
- The pharmacokinetic parameters in children are similar to adults when using equivalent mg/m² doses 3
- Cefdinir has demonstrated good clinical efficacy in pediatric patients ≥6 months of age for various respiratory tract and skin infections 2
The FDA-approved labeling provides the most current and authoritative guidance for cefdinir dosing in children, with clear weight-based dosing recommendations that optimize both efficacy and safety.