Cefixime Dosing for 8-Month-Old with Dysentery
For an 8-month-old child weighing 8 kg with dysentery, administer cefixime 8 mg/kg/day (64 mg total daily dose), which can be given as a single daily dose or divided into two doses of 4 mg/kg every 12 hours for 5 days. 1, 2
Dosing Rationale
The FDA-approved dosing for cefixime in pediatric patients 6 months or older is 8 mg/kg/day of the oral suspension, which may be administered as a single daily dose or divided into two doses of 4 mg/kg every 12 hours 1. For your 8 kg patient, this translates to 64 mg daily.
Specific Calculation for This Patient:
- Total daily dose: 8 kg × 8 mg/kg = 64 mg
- Single daily dosing: 64 mg once daily
- Divided dosing: 32 mg every 12 hours 1
Evidence for Dysentery/Shigellosis
Cefixime has demonstrated superior efficacy compared to trimethoprim-sulfamethoxazole in treating childhood shigellosis, particularly in areas with high TMP-SMX resistance 2. In a randomized controlled trial:
- Clinical cure rate: 89% with cefixime (8 mg/kg/day for 5 days) 2
- Bacteriologic cure: 78% by day 3 2
- Treatment duration: 5 days was effective 2
- Relapse rate: Infrequent in the cefixime group 2
Administration Considerations
Suspension Concentration
Cefixime oral suspension is available in two concentrations (100 mg/5 mL and 200 mg/5 mL), so always specify the concentration when prescribing in milliliters 1. For a 64 mg dose:
- Using 100 mg/5 mL concentration: 3.2 mL
- Using 200 mg/5 mL concentration: 1.6 mL
Dosing Table Reference
According to FDA dosing guidelines, for a patient weighing 7.6 to 10 kg, the recommended dose is 80 mg/day (4 mL of 100 mg/5 mL or 2 mL of 200 mg/5 mL) 1. However, the precise calculation of 8 mg/kg for your 8 kg patient yields 64 mg, which is appropriate and within the therapeutic range.
Treatment Duration
Administer for 5 days based on the shigellosis treatment trial that demonstrated excellent clinical and bacteriologic outcomes with this duration 2. This shorter course is supported by evidence showing cefixime's efficacy in pediatric bacterial infections with 5-day regimens 3, 4.
Safety Profile
Cefixime is well-tolerated in pediatric patients, with adverse events occurring in approximately 24% of patients, primarily mild gastrointestinal disturbances (diarrhea/loose stools in 16%) 4. Drug discontinuation due to adverse effects is rare (1.9%) 4.