Cefdinir Dosing and Duration
For adults and adolescents, cefdinir is dosed at 300 mg twice daily or 600 mg once daily for 5-10 days depending on the infection being treated, while pediatric patients receive 14 mg/kg/day divided into one or two doses for the same duration. 1
Adult and Adolescent Dosing
Standard dosing for adults is 300 mg orally twice daily or 600 mg orally once daily. 1, 2 The choice between once-daily and twice-daily dosing depends on the specific infection:
- For acute bacterial rhinosinusitis: 300 mg twice daily or 600 mg once daily for 10 days 3, 4
- For community-acquired pneumonia: 300 mg twice daily for 10 days 2, 5
- For acute bacterial exacerbations of chronic bronchitis: 300 mg twice daily for 5-10 days 2, 5
- For pharyngitis/tonsillitis: 300 mg twice daily or 600 mg once daily for 5-10 days 1, 5
- For uncomplicated skin and skin structure infections: 300 mg twice daily for 10 days 1, 5
Pediatric Dosing
For children, the recommended dose is 14 mg/kg/day administered as either a single daily dose or divided into two doses (7 mg/kg every 12 hours), with a maximum daily dose not exceeding 600 mg. 1, 2
Specific pediatric indications include:
- For acute otitis media: 14 mg/kg/day in one or two divided doses for 5-10 days 1, 5
- For pharyngitis/tonsillitis: 14 mg/kg/day in one or two divided doses for 5-10 days 1, 5
- For acute maxillary sinusitis: 14 mg/kg/day in one or two divided doses for 10 days 3, 1
- For uncomplicated skin infections: 14 mg/kg/day in one or two divided doses for 10 days 1, 5
Important caveat: A higher dose of 25 mg/kg once daily has been studied but was found ineffective for penicillin-nonsusceptible Streptococcus pneumoniae and is not recommended. 6 This higher dose also resulted in a 20% incidence of diarrhea without improved efficacy 6.
Duration of Therapy
Treatment duration is typically 5-10 days depending on the infection severity and type. 1, 2
- 5-day courses are appropriate for uncomplicated infections in compliant patients 2, 5
- 10-day courses are standard for most respiratory tract infections and skin infections 3, 1, 4
Special Populations
For patients with renal impairment (creatinine clearance <30 mL/min), reduce the dose to 300 mg once daily in adults or 7 mg/kg once daily in pediatric patients. 1 No dosage adjustment is needed for hepatic impairment 1.
Common Pitfalls
The most common adverse event is diarrhea, occurring in approximately 15% of adults and 8% of pediatric patients 1. Diarrhea rates are higher in children ≤2 years of age (17%) compared to older children (4%). 1 However, discontinuation rates due to adverse events are generally low (3% in adults, 2% in children) 1.