What is the recommended dosage and treatment duration of Cefdinir (Cefdinir) for bacterial infections?

Cefdinir Dosage and Treatment Duration for Bacterial Infections

The recommended dosage of cefdinir for bacterial infections in adults is 300 mg twice daily or 600 mg once daily for 10 days, while pediatric patients should receive 14 mg/kg/day divided into one or two doses (maximum 600 mg daily). 1

Adult Dosing Guidelines

• Standard adult dose: 300 mg twice daily or 600 mg once daily 1, 2
• Treatment duration: Typically 10 days for most infections 1, 3
• Maximum daily dose: 600 mg 1

Specific Adult Infections:

• Acute bacterial rhinosinusitis: 300 mg twice daily or 600 mg once daily for 10 days 1, 4
• Community-acquired pneumonia: 300 mg twice daily for 10 days 2, 5
• Acute bacterial exacerbation of chronic bronchitis: 300 mg twice daily for 5-10 days 2, 5
• Pharyngitis/tonsillitis: 300 mg twice daily for 5-10 days or 600 mg once daily for 10 days 1, 5
• Uncomplicated skin and skin structure infections: 300 mg twice daily for 10 days 1, 5

Pediatric Dosing Guidelines

• Standard pediatric dose: 14 mg/kg/day, divided into one or two doses 1
• Maximum daily dose: 600 mg (regardless of weight) 1
• Age range: Approved for children 6 months through 12 years 1

Specific Pediatric Infections:

• Acute bacterial otitis media: 7 mg/kg every 12 hours or 14 mg/kg once daily for 5-10 days 1
• Acute maxillary sinusitis: 7 mg/kg every 12 hours or 14 mg/kg once daily for 10 days 1
• Pharyngitis/tonsillitis: 7 mg/kg every 12 hours or 14 mg/kg once daily for 5-10 days 1
• Uncomplicated skin infections: 7 mg/kg every 12 hours for 10 days (note: once-daily dosing not recommended for skin infections in children) 1

Dosing in Special Populations

Renal Impairment

• Adults with creatinine clearance <30 mL/min: Reduce dose to 300 mg once daily 1
• Pediatric patients with creatinine clearance <30 mL/min/1.73 m²: Reduce dose to 7 mg/kg once daily (maximum 300 mg) 1

Hemodialysis Patients

• Initial dose: 300 mg or 7 mg/kg every other day 1
• Post-dialysis dose: 300 mg or 7 mg/kg after each hemodialysis session 1
• Maintenance: 300 mg or 7 mg/kg every other day 1

Administration Guidelines

• Can be administered without regard to meals 1
• Oral suspension should be shaken well before each administration 1
• After reconstitution, oral suspension can be stored at room temperature for up to 10 days 1

Clinical Considerations

• Cefdinir has excellent tissue distribution in respiratory tract tissues, skin, and ear fluids 2, 3
• The drug's pharmacokinetic profile allows for convenient once- or twice-daily administration 2, 3
• Cefdinir is stable to hydrolysis by common beta-lactamases, making it effective against beta-lactamase-producing strains of H. influenzae and M. catarrhalis 3, 5

Common Side Effects and Monitoring

• Diarrhea is the most common adverse event, occurring more frequently than with some comparator antibiotics 3, 5
• Despite higher incidence of diarrhea, discontinuation rates due to adverse events are generally similar to comparator agents 3
• The pediatric oral suspension has shown superior taste compared to other oral antimicrobial agents 2

Important Caveats

• Avoid concurrent administration with antacids containing aluminum or magnesium, as these may decrease absorption of cefdinir 3
• Iron supplements and iron-fortified foods can also reduce cefdinir absorption 3
• For skin infections in children, twice-daily dosing is required as once-daily dosing has not been studied for this indication 1

Cefdinir represents an important option for treating mild to moderate bacterial infections, particularly in areas with high rates of beta-lactamase production or resistance to other commonly used agents such as macrolides, penicillins, and trimethoprim-sulfamethoxazole 2.