Cefdinir (Omnicef) Dosing Recommendations
For adults, cefdinir should be dosed at 300 mg twice daily or 600 mg once daily, and for children, 14 mg/kg/day divided into one or two doses (not exceeding 600 mg daily). 1
Adult Dosing
- Standard adult dose: 300 mg twice daily or 600 mg once daily for 10 days 1, 2
- Maximum daily dose: 600 mg 1
- Administration: Can be taken without regard to meals 1
- Duration: Typically 5-10 days depending on infection type 2, 3
Pediatric Dosing
Children 6 months through 12 years:
- Standard pediatric dose: 14 mg/kg/day, divided as follows 1:
- Once-daily dosing: 14 mg/kg once daily
- Twice-daily dosing: 7 mg/kg every 12 hours
- Maximum daily dose: 600 mg 1
Dosing by infection type:
Acute bacterial otitis media:
- 7 mg/kg every 12 hours for 5-10 days, OR
- 14 mg/kg once daily for 10 days 1
Acute maxillary sinusitis:
- 7 mg/kg every 12 hours for 10 days, OR
- 14 mg/kg once daily for 10 days 1
Pharyngitis/Tonsillitis:
- 7 mg/kg every 12 hours for 5-10 days, OR
- 14 mg/kg once daily for 10 days 1
Uncomplicated skin and skin structure infections:
- 7 mg/kg every 12 hours for 10 days (note: once-daily dosing not studied for skin infections) 1
Dosing in Special Populations
Renal Impairment
- Adults with creatinine clearance <30 mL/min: 300 mg once daily 1
- Pediatric patients with creatinine clearance <30 mL/min/1.73 m²: 7 mg/kg (up to 300 mg) once daily 1
Hemodialysis Patients
- 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 Pearls
- Cefdinir is an oral third-generation cephalosporin effective against common respiratory and skin pathogens 2, 3
- The suspension formulation is available in two concentrations: 125 mg/5 mL and 250 mg/5 mL 1
- After reconstitution, the suspension can be stored at room temperature for 10 days 1
- Diarrhea is the most common adverse effect 3
- Cefdinir has shown good distribution into respiratory tissues, skin, and middle ear fluid 2
- For most infections, once-daily dosing is as effective as twice-daily dosing, improving compliance 1, 2
- Cefdinir is particularly useful in areas with high rates of beta-lactamase production in H. influenzae and M. catarrhalis 2, 3
Common Pitfalls to Avoid
- Do not exceed 600 mg total daily dose in any patient 1
- For skin infections, only use twice-daily dosing as once-daily dosing has not been studied for this indication 1
- Shake the suspension well before each administration 1
- Discard any unused suspension after 10 days 1
- Be aware that cefdinir may be less effective against penicillin-resistant S. pneumoniae compared to some other antibiotics 3
- Cefdinir is not indicated for severe or life-threatening infections where parenteral therapy would be more appropriate