Cefdinir Dosing for a 56-Pound Pediatric Patient
For a 56-pound (approximately 25.5 kg) pediatric patient, the recommended dose of cefdinir is 14 mg/kg/day, which equals approximately 357 mg per day, divided as either 178.5 mg twice daily or the full 357 mg once daily depending on the infection being treated.
Dosing Calculation
- 56 pounds = 25.5 kg
- Standard pediatric dose: 14 mg/kg/day 1
- Total daily dose: 25.5 kg × 14 mg/kg = 357 mg/day
- Maximum daily dose: 600 mg per day 1
Administration Options
- Once-daily dosing (357 mg once daily) for:
- Twice-daily dosing (178.5 mg twice daily) for:
- Uncomplicated skin and skin structure infections 1
Duration of Therapy
- Acute bacterial otitis media: 10 days 1
- Acute maxillary sinusitis: 10 days 1
- Pharyngitis/tonsillitis: 5-10 days 1
- Uncomplicated skin and skin structure infections: 10 days 1
Clinical Considerations
- Cefdinir can be administered without regard to meals 1
- For a child weighing 60 pounds (27 kg), the FDA-approved dosing chart recommends:
- 7.5 mL of 125 mg/5 mL suspension twice daily OR
- 15 mL of 125 mg/5 mL suspension once daily OR
- 3.75 mL of 250 mg/5 mL suspension twice daily OR
- 7.5 mL of 250 mg/5 mL suspension once daily 1
Efficacy Considerations
- Cefdinir is effective against common respiratory pathogens including Haemophilus influenzae, Moraxella catarrhalis, and penicillin-susceptible Streptococcus pneumoniae 2
- It is stable against commonly occurring plasmid-mediated β-lactamases and maintains good activity against β-lactamase-producing strains of H. influenzae 3
- For penicillin-resistant S. pneumoniae, standard cefdinir dosing may have limited efficacy 4
Safety Profile
- Most common adverse effect is diarrhea 3
- In studies of higher dosing (25 mg/kg/day), diarrhea occurred in approximately 20% of pediatric patients 5
- The suspension may be used for 10 days after reconstitution, after which any unused portion must be discarded 1
Important Caveats
- For patients with renal insufficiency (creatinine clearance <30 mL/min/1.73 m²), the dose should be reduced to 7 mg/kg once daily (up to 300 mg) 1
- Higher doses (25 mg/kg/day) have been studied but were found ineffective for treatment of acute otitis media caused by penicillin-nonsusceptible S. pneumoniae and had higher rates of diarrhea 5
- Cefdinir is considered an alternative therapy for children with acute otitis media who have type 1 hypersensitivity to beta-lactams 5