What is the recommended dosing for cefdinir (Omnicef) in adults and children?

Cefdinir Dosing

Cefdinir is dosed at 300 mg twice daily or 600 mg once daily in adults and adolescents, and 14 mg/kg/day (maximum 600 mg/day) in one or two divided doses in pediatric patients aged 6 months through 12 years, with treatment duration typically 5-10 days depending on the infection type. 1

Adult and Adolescent Dosing

• Standard dose: 300 mg orally twice daily OR 600 mg orally once daily 1, 2
• Treatment duration: 5-10 days depending on infection type 1, 3
• Cefdinir may be administered without regard to meals 1

Renal Impairment Adjustments in Adults

• Creatinine clearance <30 mL/min: Reduce dose to 300 mg once daily 1
• Hemodialysis patients: 300 mg every other day, with an additional 300 mg dose given at the conclusion of each hemodialysis session 1

Pediatric Dosing (Age 6 Months Through 12 Years)

The total daily dose for all infections is 14 mg/kg, up to a maximum of 600 mg per day 1

Dosing by Infection Type

• Acute bacterial otitis media: 7 mg/kg every 12 hours OR 14 mg/kg every 24 hours for 5-10 days (once-daily: 10 days) 1
• Acute maxillary sinusitis: 7 mg/kg every 12 hours OR 14 mg/kg every 24 hours for 10 days 1
• Pharyngitis/tonsillitis: 7 mg/kg every 12 hours OR 14 mg/kg every 24 hours for 5-10 days (once-daily: 10 days) 1
• Uncomplicated skin and skin structure infections: 7 mg/kg every 12 hours for 10 days (once-daily dosing has NOT been studied for skin infections) 1

Weight-Based Dosing Chart (Pediatric)

For patients weighing ≥43 kg, administer the maximum daily dose of 600 mg 1:

• 9 kg (20 lbs): 2.5 mL (125 mg/5 mL) every 12 hours OR 5 mL every 24 hours 1
• 18 kg (40 lbs): 5 mL (125 mg/5 mL) every 12 hours OR 2.5 mL (250 mg/5 mL) every 12 hours 1
• 27 kg (60 lbs): 7.5 mL (125 mg/5 mL) every 12 hours OR 3.75 mL (250 mg/5 mL) every 12 hours 1
• 36 kg (80 lbs): 10 mL (125 mg/5 mL) every 12 hours OR 5 mL (250 mg/5 mL) every 12 hours 1
• ≥43 kg (95 lbs): 12 mL (125 mg/5 mL) every 12 hours OR 6 mL (250 mg/5 mL) every 12 hours 1

Renal Impairment Adjustments in Pediatrics

• Creatinine clearance <30 mL/min/1.73 m²: Reduce dose to 7 mg/kg (up to 300 mg) once daily 1
• Hemodialysis patients: 7 mg/kg every other day, with an additional 7 mg/kg dose given at the conclusion of each hemodialysis session 1

Important Clinical Considerations

Once-Daily vs. Twice-Daily Dosing

• Once-daily dosing for 10 days is as effective as twice-daily dosing for respiratory tract infections 1, 2
• Exception: Once-daily dosing has NOT been studied in skin infections; therefore, administer twice daily for these infections 1

Suspension Preparation and Storage

• After mixing, suspension can be stored at room temperature (25°C/77°F) in a tightly closed container 1
• Shake well before each administration 1
• Discard any unused portion after 10 days 1

Common Pitfalls to Avoid

• Do not use once-daily dosing for skin and skin structure infections, as this has not been validated 1
• Ensure dose adjustment in renal impairment to prevent drug accumulation 1
• For hemodialysis patients, remember the post-dialysis supplemental dose to maintain therapeutic levels 1