What is the typical dosage and treatment duration for cefdinir (Cefdinir) in bacterial infections?

Cefdinir Dosage and Treatment Duration for Bacterial Infections

Cefdinir is typically dosed at 300 mg twice daily or 600 mg once daily for adults, and 14 mg/kg/day divided into one or two doses for children, with treatment durations ranging from 5-10 days depending on the specific infection. 1

Adult Dosing

Standard Adult Dosing

• 300 mg twice daily or 600 mg once daily, depending on the infection type 1, 2
• Once-daily dosing (600 mg) is appropriate for most respiratory tract infections 3
• Twice-daily dosing (300 mg) is recommended for skin and skin structure infections 1

Duration of Treatment for Adults

• Acute bacterial otitis media: 5-10 days 1
• Acute maxillary sinusitis: 10 days 1, 4
• Pharyngitis/tonsillitis: 5-10 days 1
• Uncomplicated skin and skin structure infections: 10 days 1
• Community-acquired pneumonia: 10 days 3
• Acute bacterial exacerbations of chronic bronchitis: 10 days 3

Pediatric Dosing

Standard Pediatric Dosing (6 months through 12 years)

• Total daily dose: 14 mg/kg/day, up to maximum of 600 mg per day 1
• Can be administered as:
  • 7 mg/kg twice daily (every 12 hours) or
  • 14 mg/kg once daily (every 24 hours) 1

Duration of Treatment for Children

• Acute bacterial otitis media: 5-10 days (10 days for once-daily dosing) 1
• Acute maxillary sinusitis: 10 days 1
• Pharyngitis/tonsillitis: 5-10 days (10 days for once-daily dosing) 1
• Uncomplicated skin and skin structure infections: 10 days (must use twice-daily dosing) 1

Special Populations

Renal Impairment

• For adults with creatinine clearance <30 mL/min: 300 mg once daily 1
• For 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 1
• After each hemodialysis session: 300 mg or 7 mg/kg should be administered 1
• Subsequent doses: 300 mg or 7 mg/kg every other day 1

Clinical Efficacy

• Effective against common respiratory pathogens including Haemophilus influenzae, Moraxella catarrhalis, and penicillin-susceptible Streptococcus pneumoniae 2
• Stable against commonly occurring plasmid-mediated beta-lactamases 2
• Shows good distribution into respiratory tissues (sinus, tonsil) and fluids (middle ear) 2, 3
• Clinical and bacteriological efficacy comparable to other oral antibiotics like amoxicillin/clavulanate, cefprozil, and cephalexin in controlled trials 2, 5

Administration Considerations

• May be administered without regard to meals 1
• Oral suspension must be shaken well before each administration 1
• After reconstitution, oral suspension can be stored at room temperature for 10 days 1
• Diarrhea is the most common adverse effect, occurring in approximately 20% of patients 5

Advantages

• Convenient once or twice daily dosing improves compliance 3
• Good option in areas with high rates of beta-lactamase producing organisms 3
• Oral suspension has superior taste compared to many other antibiotic suspensions, improving pediatric compliance 3

Common Pitfalls to Avoid

• Once-daily dosing has not been studied for skin infections; always use twice-daily dosing for skin infections 1
• Do not exceed maximum daily dose of 600 mg, even in severe infections 1
• Discard unused oral suspension after 10 days 1
• Monitor for diarrhea, which is the most common adverse event 2, 5