Cefixime Dosing Guidelines for Pediatric Patients
The recommended dose of cefixime for pediatric patients 6 months or older is 8 mg/kg/day, which may be administered as a single daily dose or divided into two doses of 4 mg/kg every 12 hours. 1
Dosage Recommendations by Age and Weight
Pediatric Patients (6 months to 12 years)
- Standard dose: 8 mg/kg/day as a single daily dose or divided into two doses 1
- Available in two concentrations:
- 100 mg/5 mL suspension
- 200 mg/5 mL suspension
Weight-Based Dosing Chart
| Patient Weight (kg) | Daily Dose (mg) | 100 mg/5 mL Suspension (mL) | 200 mg/5 mL Suspension (mL) |
|---|---|---|---|
| 5 to 7.5 | 50 | 2.5 | - |
| 7.6 to 10 | 80 | 4 | 2 |
| 10.1 to 12.5 | 100 | 5 | 2.5 |
| 12.6 to 20.5 | 150 | 7.5 | 4 |
| 20.6 to 28 | 200 | 10 | 5 |
| 28.1 to 33 | 250 | 12.5 | 6 |
| 33.1 to 40 | 300 | 15 | 7.5 |
| 40.1 to 45 | 350 | 17.5 | 9 |
| >45 | 400 | 20 | 10 |
Special Considerations
- Children weighing more than 45 kg or older than 12 years should receive the adult dose of 400 mg daily 1
- For otitis media, the suspension formulation should be used rather than tablets or capsules, as clinical trials demonstrated higher peak blood levels with the suspension 1
Duration of Therapy
The duration of therapy depends on the type of infection being treated:
- Streptococcal pharyngitis: Minimum 10 days 1, 2
- Urinary tract infections: 7-10 days 3, 4
- Respiratory tract infections: 10-14 days 2, 5
Dosage Adjustments for Renal Impairment
For pediatric patients with renal impairment, dose adjustment should follow these guidelines:
- Creatinine clearance ≥60 mL/min: Normal dose
- Creatinine clearance 21-59 mL/min: 75% of normal dose
- Creatinine clearance ≤20 mL/min or on dialysis: 50% of normal dose 1
Administration Guidelines
- Cefixime suspension may be administered without regard to food
- After reconstitution, the suspension remains stable for 14 days at room temperature or refrigerated
- Shake well before each use 1
Clinical Efficacy and Safety
Cefixime has demonstrated excellent efficacy in pediatric patients for various infections:
- 98-100% clinical cure or improvement in respiratory tract infections 5
- 94-98% cure rates in urinary tract infections 3, 4
- Common side effects include diarrhea or loose stools (16% of patients), but these are generally mild and rarely require discontinuation of therapy 2
Important Clinical Considerations
- For streptococcal infections, ensure a full 10-day course to prevent rheumatic fever
- Once-daily dosing may improve adherence compared to multiple daily doses
- Cefixime provides broad-spectrum coverage against common pediatric pathogens including Streptococcus pyogenes, Escherichia coli, and Streptococcus pneumoniae 2, 5
When treating pediatric patients, always verify the concentration of cefixime suspension (100 mg/5 mL or 200 mg/5 mL) before prescribing to ensure accurate dosing.