Cefdinir Dosage and Treatment Duration Guidelines
For adults, cefdinir should be administered at 300 mg twice daily or 600 mg once daily for 10 days for most infections. For children, the recommended dosage is 14 mg/kg/day divided into one or two doses, not exceeding 600 mg daily, also typically for 10 days 1.
Adult Dosing
Standard Dosing
- 300 mg twice daily OR 600 mg once daily
- Duration: 10 days for most infections
Specific Conditions
- Acute Bacterial Rhinosinusitis: 600 mg once daily or 300 mg twice daily for 10 days 1, 2
- Community-Acquired Pneumonia: 300 mg twice daily for 10 days 3
- Acute Bacterial Exacerbation of Chronic Bronchitis: 300 mg twice daily for 5-10 days 4
- Pharyngitis/Tonsillitis: 300 mg twice daily for 5-10 days 4
- Uncomplicated Skin Infections: 300 mg twice daily for 10 days 3
Pediatric Dosing
- 14 mg/kg/day divided into one or two doses 3
- Maximum daily dose: 600 mg
- Duration: 10 days for most infections
- Appropriate for: Children ≥6 months of age 4
Special Considerations
Renal Impairment
- Dosage adjustment required for patients with creatinine clearance <30 mL/min
- For adults with CrCl <30 mL/min: 300 mg once daily
- For patients on hemodialysis: 300 mg every other day
Administration Guidelines
- May be taken with or without food
- Avoid taking with iron supplements or iron-fortified foods as they can reduce absorption
- Space administration of antacids containing aluminum or magnesium by at least 2 hours
Clinical Efficacy
Cefdinir has demonstrated efficacy comparable to other antibiotics in treating various infections:
- In acute bacterial rhinosinusitis, cefdinir (both once-daily and twice-daily regimens) showed approximately 90% cure rates, similar to amoxicillin-clavulanate 5
- For respiratory tract infections, cefdinir showed equivalent efficacy to cefprozil, loracarbef, cefuroxime axetil, and cefaclor 4
- In pediatric patients, cefdinir showed similar efficacy to amoxicillin/clavulanate and cefprozil in acute otitis media 4
Antimicrobial Spectrum
Cefdinir is effective against common respiratory and skin pathogens:
- Good coverage against Haemophilus influenzae and Moraxella catarrhalis, including β-lactamase-producing strains 4
- Active against penicillin-susceptible Streptococcus pneumoniae 4
- Effective against Streptococcus pyogenes and methicillin-susceptible Staphylococcus aureus 6
Common Side Effects and Precautions
- Most common adverse effect: Diarrhea (occurs in approximately 20% of patients) 5
- Generally well-tolerated with discontinuation rates similar to comparator antibiotics 4
- Superior taste/palatability of oral suspension compared to other antibiotics, improving adherence in pediatric patients 3, 2
Treatment Selection Considerations
Cefdinir is particularly appropriate in:
- Areas with high rates of β-lactamase production in H. influenzae 3
- Patients requiring once-daily dosing for improved adherence 2
- Pediatric patients who may refuse other antibiotics due to taste issues 3
- Patients with mild-to-moderate respiratory tract or skin infections 4
Cefdinir offers the advantage of convenient once- or twice-daily dosing with good efficacy against common respiratory and skin pathogens, making it an excellent choice when patient adherence is a concern or when β-lactamase-producing organisms are suspected.