What is the recommended dose of cefdinir (Cefdinir) for a 12-year-old patient weighing 85 pounds with an ear infection?

Recommended Cefdinir Dosage for a 12-Year-Old with Ear Infection

For a 12-year-old child weighing 85 pounds (approximately 38.6 kg) with an ear infection, the recommended dose of cefdinir is 14 mg/kg once daily for 10 days, which equals approximately 540 mg once daily or 270 mg twice daily.

Dosage Calculation

The FDA-approved dosing for cefdinir in pediatric patients with acute bacterial otitis media provides two equivalent options:

• Once-daily dosing: 14 mg/kg once daily for 10 days 1
• Twice-daily dosing: 7 mg/kg twice daily for 5-10 days 1

For this 12-year-old patient weighing 85 pounds (38.6 kg):

• Once-daily dose: 38.6 kg × 14 mg/kg = 540.4 mg (rounded to 540 mg) once daily
• Twice-daily dose: 38.6 kg × 7 mg/kg = 270.2 mg (rounded to 270 mg) twice daily

Administration Considerations

• Cefdinir may be administered without regard to meals 1
• The suspension should be shaken well before each administration 1
• The maximum daily dose should not exceed 600 mg 1

Formulation Options

For a 12-year-old patient, either the capsule or suspension formulation can be used:

• Capsules: Available as 300 mg capsules
• Suspension: Available as 125 mg/5 mL or 250 mg/5 mL 1

For the calculated dose of 540 mg once daily:

• Using 250 mg/5 mL suspension: 10.8 mL (approximately 11 mL) once daily
• Using capsules: One 300 mg capsule plus one partial capsule (not ideal) or two 300 mg capsules (600 mg, the maximum daily dose)

Clinical Efficacy for Otitis Media

Cefdinir has demonstrated good clinical efficacy in the treatment of acute otitis media in pediatric patients:

• Clinical cure rates of 80% have been reported in pediatric patients with acute otitis media treated with cefdinir 14 mg/kg/day divided twice daily for 5 days 2
• Cefdinir provides good coverage against common otitis media pathogens, including Haemophilus influenzae, Moraxella catarrhalis, and penicillin-susceptible Streptococcus pneumoniae 3

Potential Side Effects and Monitoring

• The most common adverse event is diarrhea, occurring in approximately 7.8% of pediatric patients 2
• Other potential side effects include nausea, abdominal pain, and rash 3
• Monitor for allergic reactions, especially in patients with known hypersensitivity to cephalosporins or penicillins 1

Duration of Treatment

• For acute bacterial otitis media, the recommended duration is 10 days for once-daily dosing 1
• For twice-daily dosing, the duration can be 5-10 days, with 10 days generally preferred for complete eradication of pathogens 1, 2

Special Considerations

• Cefdinir is stable to hydrolysis by commonly occurring plasmid-mediated beta-lactamases and retains good activity against beta-lactamase-producing strains of H. influenzae and M. catarrhalis 3
• For patients with renal insufficiency (creatinine clearance <30 mL/min/1.73 m²), dose adjustment is required 1
• The suspension can be stored at room temperature for up to 10 days after reconstitution 1