Cefixime Dosing for Children
The recommended dose of cefixime for pediatric patients 6 months or older is 8 mg/kg/day, which can be administered as a single daily dose or divided into 4 mg/kg every 12 hours. 1
Standard Dosing Regimen
- For children 6 months or older, administer 8 mg/kg/day of the oral suspension 1
- This total daily dose may be given either:
- As a single daily dose, OR
- Divided as 4 mg/kg every 12 hours 1
Weight-Based Dosing Table
The FDA label provides specific milliliter doses based on weight ranges to simplify administration 1:
- 5 to 7.5 kg: 50 mg/day (2.5 mL of 100 mg/5 mL suspension) 1
- 7.6 to 10 kg: 80 mg/day (4 mL of 100 mg/5 mL or 2 mL of 200 mg/5 mL) 1
- 10.1 to 12.5 kg: 100 mg/day (5 mL of 100 mg/5 mL or 2.5 mL of 200 mg/5 mL) 1
- 12.6 to 20.5 kg: 150 mg/day (7.5 mL of 100 mg/5 mL or 4 mL of 200 mg/5 mL) 1
- 20.6 to 28 kg: 200 mg/day (10 mL of 100 mg/5 mL or 5 mL of 200 mg/5 mL) 1
- 28.1 to 33 kg: 250 mg/day (12.5 mL of 100 mg/5 mL or 6 mL of 200 mg/5 mL) 1
- 33.1 to 40 kg: 300 mg/day (15 mL of 100 mg/5 mL or 7.5 mL of 200 mg/5 mL) 1
- 40.1 to 45 kg: 350 mg/day (17.5 mL of 100 mg/5 mL or 9 mL of 200 mg/5 mL) 1
- Greater than 45 kg or older than 12 years: Use adult dose of 400 mg daily 1
Critical Administration Details
- Cefixime may be administered without regard to food 1
- Always specify the concentration when prescribing in milliliters, as cefixime suspension is available in two concentrations: 100 mg/5 mL and 200 mg/5 mL 1
- For otitis media, the suspension must be used rather than tablets or capsules, as the suspension achieves higher peak blood levels at the same dose 1
Duration of Therapy
- For Streptococcus pyogenes infections, administer for at least 10 days 1
- For other indications, typical treatment courses range from 10-14 days 2
Supporting Evidence
Clinical trials have demonstrated that the 8 mg/kg/day dosing regimen is both safe and effective 2, 3. In a multicenter trial of 206 children with pharyngitis, cystitis, or pneumonia, once-daily cefixime at 8 mg/kg showed clinical failure in only 1.8% of evaluable patients, with drug-related adverse effects (primarily mild diarrhea) occurring in 24.3% 2. A comparative UTI study confirmed that oral cefixime 8 mg/kg/day for 10 days achieved 92% cure rates with no serious adverse effects 3.