Cefdinir Dosing for Sinus Infection

For adults with acute bacterial sinusitis, cefdinir should be dosed at 300 mg twice daily or 600 mg once daily for 10 days. 1, 2

Adult Dosing Regimen

The standard adult dose is 300 mg orally twice daily for 10 days, which has demonstrated approximately 90% clinical cure rates in randomized controlled trials 3, 4
An alternative once-daily regimen of 600 mg once daily for 10 days is equally effective and may improve adherence 3, 5
Both dosing schedules achieve equivalent clinical and bacteriological efficacy against the primary sinusitis pathogens (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis) 3, 6

For acute maxillary sinusitis in children, the dose is 7 mg/kg every 12 hours OR 14 mg/kg once daily (maximum 600 mg/day) for 10 days 2
The total daily dose for all infections is 14 mg/kg, up to a maximum of 600 mg per day 2
Once-daily dosing for 10 days is as effective as twice-daily dosing in pediatric patients 2

Cefdinir is recommended as a first-line option for adults with mild acute bacterial sinusitis who have not received antibiotics in the previous 4-6 weeks 1
It ranks in the 83-88% predicted clinical efficacy tier, slightly below respiratory fluoroquinolones (90-92%) but comparable to high-dose amoxicillin and other advanced cephalosporins 1
Cefdinir is an appropriate alternative for patients with penicillin allergy, as second- and third-generation cephalosporins have negligible cross-reactivity risk 1, 7

For creatinine clearance <30 mL/min in adults: reduce dose to 300 mg once daily 2
For pediatric patients with creatinine clearance <30 mL/min/1.73 m²: reduce dose to 7 mg/kg (up to 300 mg) once daily 2

Initial dose: 300 mg (or 7 mg/kg) every other day 2
At the conclusion of each hemodialysis session: give 300 mg (or 7 mg/kg), then continue every other day 2

Cefdinir demonstrates approximately 90% clinical cure rates in acute bacterial sinusitis, equivalent to amoxicillin-clavulanate 3, 4
Microbiological eradication rates are similar to amoxicillin-clavulanate across all major sinusitis pathogens 3
The drug provides excellent coverage against β-lactamase-producing strains of H. influenzae and M. catarrhalis, which account for nearly 50% and 90-100% of isolates respectively in most geographic areas 1, 4

The most common adverse effect is mild diarrhea, occurring in approximately 20% of patients 3
Cefdinir causes fewer adverse events requiring treatment discontinuation compared to amoxicillin-clavulanate 3
The oral suspension has superior taste and palatability ratings compared to other oral antimicrobials, improving pediatric compliance 5, 6

If no improvement occurs after 72 hours, switch to alternative therapy or re-evaluate the diagnosis 1
Consider switching to high-dose amoxicillin-clavulanate (4 g/250 mg per day) or a respiratory fluoroquinolone (levofloxacin, moxifloxacin) 1, 7
For adults with moderate disease or recent antibiotic exposure (within 4-6 weeks), respiratory fluoroquinolones or high-dose amoxicillin-clavulanate should be used as initial therapy instead of cefdinir 1

Cefdinir may be administered without regard to meals 2
After mixing, the oral suspension can be stored at room temperature (25°C/77°F) in a tightly closed container 2
Shake suspension well before each administration 2
The suspension may be used for 10 days after mixing, after which any unused portion must be discarded 2

Do not use cefdinir for patients with moderate-to-severe disease or recent antibiotic exposure—these patients require more aggressive initial therapy 1
Avoid using first-generation cephalosporins (cephalexin, cefadroxil) or cefaclor for sinusitis, as they have inadequate coverage against H. influenzae and high rates of adverse reactions 1
Complete the full 10-day course even if symptoms improve earlier to prevent relapse and resistance development 7, 4
Reassess at 72 hours if no improvement to avoid delayed treatment of resistant organisms 1, 7