Cefdinir (Omnicef) Liquid Dosage and Usage for Bacterial Infections
For pediatric patients (6 months through 12 years), cefdinir oral suspension should be dosed at 14 mg/kg/day, divided as either 7 mg/kg twice daily or 14 mg/kg once daily, up to a maximum of 600 mg per day. 1
Dosing by Infection Type
Respiratory Tract 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
Skin and Skin Structure Infections
- Uncomplicated Skin Infections: 7 mg/kg every 12 hours for 10 days 1
- Note: Once-daily dosing has not been studied for skin infections, so twice-daily administration is recommended 1
Pediatric Dosing Chart
| Weight | 125 mg/5 mL | 250 mg/5 mL |
|---|---|---|
| 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 |
Administration Considerations
- Cefdinir suspension may be administered without regard to meals 1
- After mixing, the suspension can be stored at room temperature in a tightly closed container 1
- The suspension should be shaken well before each administration 1
- The mixed suspension may be used for 10 days, after which any unused portion must be discarded 1
Special Populations
Patients with Renal Insufficiency
- For pediatric patients with creatinine clearance <30 mL/min/1.73 m², the dose should be reduced to 7 mg/kg (up to 300 mg) given once daily 1
Patients on Hemodialysis
- Initial dose: 300 mg or 7 mg/kg every other day
- After each hemodialysis session: 300 mg or 7 mg/kg
- Subsequent doses: 300 mg or 7 mg/kg every other day 1
Clinical Efficacy and Spectrum of Activity
- Cefdinir is an oral third-generation cephalosporin with good activity against common respiratory and skin infection pathogens, including:
- It is stable to hydrolysis by commonly occurring plasmid-mediated beta-lactamases 3
Advantages and Considerations
- The oral suspension has superior taste and palatability compared to other antimicrobial agents, improving adherence in pediatric patients 2
- Once-daily dosing option (except for skin infections) provides convenience 3
- Cefdinir is well-tolerated with diarrhea being the most common adverse event 3
Important Caveats
- For skin infections, only the twice-daily regimen has been studied and should be used 1
- Cefdinir has lower activity against H. influenzae compared to cefpodoxime proxetil 4
- Not effective against drug-resistant S. pneumoniae (DRSP) 4
- In areas with high prevalence of penicillin-resistant S. pneumoniae, alternative agents may be considered 5
When treating bacterial infections in children, cefdinir liquid provides a convenient and palatable option with good efficacy against common pathogens and a favorable safety profile.