What is the recommended dose of Cefixime (Cefixime) for a 12-year-old boy weighing 27kg?

Cefixime Dosing for a 12-Year-Old Boy Weighing 27kg

The recommended dose of cefixime for a 12-year-old boy weighing 27kg is 8 mg/kg/day, which equals 216 mg per day, administered as a single daily dose or divided into two doses of 108 mg every 12 hours. 1

Dosing Calculation and Administration

According to the FDA drug label for cefixime, the recommended pediatric dose is 8 mg/kg/day for patients 6 months or older 1. For a 27kg child, this calculates to:

• 8 mg/kg/day × 27kg = 216 mg/day

This can be administered as:

• Single daily dose: 216 mg once daily
• Divided dose: 108 mg every 12 hours (preferred for better gastrointestinal tolerance)

Based on the FDA-approved pediatric dosage chart, a child weighing between 20.6 to 28 kg should receive 200 mg per day, which is the closest standardized dose to our calculated 216 mg 1.

Administration Options

The medication can be given as:

• Oral suspension: 200 mg/5 mL (5 mL daily) or 100 mg/5 mL (10 mL daily)
• For a 27kg child, the 200 mg/5 mL concentration is most appropriate at 5 mL daily

Important Clinical Considerations

1. Duration of Treatment:

   • For most infections: 5-7 days
   • For Streptococcus pyogenes infections: minimum 10 days 1

2. Renal Function:

   • Normal dose can be used for patients with creatinine clearance ≥60 mL/min
   • Dose adjustment required for impaired renal function 1

3. Administration Timing:

   • Can be administered without regard to food 1
   • Dividing the daily dose into two administrations may improve gastrointestinal tolerance 2

Clinical Efficacy and Safety

Cefixime has demonstrated efficacy in pediatric patients for:

• Respiratory tract infections
• Urinary tract infections
• Otitis media (ear infection)

The medication has shown a good safety profile in children with mild gastrointestinal side effects being the most common adverse reaction 3.

Potential Pitfalls and Caveats

1. Concentration Awareness:

   • Ensure the correct concentration is specified when prescribing the oral suspension, as cefixime is available in two different concentrations (100 mg/5 mL and 200 mg/5 mL) 1

2. Limited Activity Against Certain Pathogens:

   • Cefixime has little activity against Staphylococcus aureus and is inactive against Pseudomonas aeruginosa 4

3. Gastrointestinal Side Effects:

   • Consider dividing the daily dose into two administrations to reduce the incidence of gastrointestinal adverse effects 2

4. Storage After Reconstitution:

   • After reconstitution, the suspension may be kept for 14 days either at room temperature or under refrigeration 1

By following these dosing guidelines, cefixime can be safely and effectively administered to this 12-year-old patient while minimizing potential adverse effects.