What is the recommended dosage of cefixime (cephalosporin antibiotic) for a 4-year-old child?

Cefixime Dosage for a 4-Year-Old Child

The recommended dosage of cefixime for a 4-year-old child is 8 mg/kg/day, which can be administered as a single daily dose or divided into two doses of 4 mg/kg every 12 hours. 1

Dosage Calculation Based on Weight

For a 4-year-old child, the specific dose depends on the child's weight:

• For a child weighing between 12.6-20.5 kg: 150 mg/day (7.5 mL of 100 mg/5 mL suspension or 4 mL of 200 mg/5 mL suspension) 1
• For a child weighing between 20.6-28 kg: 200 mg/day (10 mL of 100 mg/5 mL suspension or 5 mL of 200 mg/5 mL suspension) 1

Administration Guidelines

• Cefixime oral suspension is available in two concentrations: 100 mg/5 mL and 200 mg/5 mL 1
• The medication can be given once daily or divided into two doses 1
• For infections due to Streptococcus pyogenes, treatment should continue for at least 10 days 1
• After reconstitution, the suspension may be kept for 14 days either at room temperature or refrigerated 1

Indications for Use in Children

Cefixime is indicated for children 6 months or older for:

• Uncomplicated urinary tract infections caused by E. coli and P. mirabilis 1
• Otitis media caused by H. influenzae, M. catarrhalis, and S. pyogenes 1
• Pharyngitis and tonsillitis caused by S. pyogenes 1
• Acute exacerbations of chronic bronchitis caused by S. pneumoniae and H. influenzae 1

Clinical Efficacy

• Clinical studies have shown high efficacy rates (98.0%) in children with respiratory tract infections when treated with cefixime at 8 mg/kg/day 2
• In pediatric patients with pharyngitis, cystitis, or pneumonia, clinical failure occurred in only 1.8% of cases when treated with cefixime 8 mg/kg once daily 3

Safety Considerations

• The most common adverse effects in children are gastrointestinal disturbances, particularly diarrhea or loose stools (16% of pediatric patients) 3
• Most adverse events are mild and rarely require discontinuation of therapy (only 1.9% of cases) 3
• The dry syrup formulation has high acceptance rates among children (96.7% reported as very well or well accepted) 2

Important Caveats

• Ensure that all orders specifying a dose in milliliters include the concentration, as cefixime is available in two different concentrations 1
• For otitis media, only use the suspension formulation, not tablets or capsules, as clinical trials showed the suspension results in higher peak blood levels 1
• Penicillin remains the drug of choice for S. pyogenes infections; cefixime is an alternative when appropriate 1
• While cefixime is effective in eradicating S. pyogenes from the nasopharynx, data establishing its efficacy in preventing rheumatic fever is not available 1

By following these dosage recommendations and administration guidelines, cefixime can be safely and effectively used in a 4-year-old child for appropriate bacterial infections.