Cefdinir Dosing for a 10-Year-Old Weighing 90 Pounds
For a 10-year-old child weighing 90 pounds (41 kg), the recommended dose of cefdinir is 14 mg/kg/day, which equals 574 mg per day, administered either as 287 mg twice daily or 574 mg once daily, not to exceed the maximum daily dose of 600 mg. 1
Weight-Based Dosing Calculation
- The patient weighs 90 pounds (40.8 kg), which falls into the ≥43 kg dosing category per FDA guidelines 1
- For pediatric patients weighing ≥43 kg (95 lbs), the maximum daily dose is 600 mg, administered as either 300 mg twice daily or 600 mg once daily 1
- Since this patient weighs slightly less at 90 pounds, the precise calculation of 14 mg/kg/day yields approximately 570 mg daily, which can be rounded to the practical dosing of 300 mg twice daily 1
Dosing Regimen Options
Twice-daily dosing: 7 mg/kg every 12 hours (approximately 285 mg twice daily, rounded to 300 mg twice daily for practical administration) 1
Once-daily dosing: 14 mg/kg every 24 hours (approximately 570 mg once daily, rounded to 600 mg once daily) 1
- Once-daily dosing for 10 days has been proven as effective as twice-daily dosing in clinical trials 1, 2
- However, once-daily dosing has not been studied specifically for skin infections, so twice-daily administration should be used for uncomplicated skin and skin structure infections 1
Duration of Treatment by Indication
Acute bacterial otitis media: 5-10 days (twice daily) or 10 days (once daily) 1
Acute maxillary sinusitis: 10 days for both dosing regimens 1
Pharyngitis/tonsillitis: 5-10 days (twice daily) or 10 days (once daily) 1
Uncomplicated skin and skin structure infections: 10 days (twice daily only) 1
Practical Administration Using Oral Suspension
For a 90-pound child using the 250 mg/5 mL suspension strength:
Twice-daily regimen: 6 mL every 12 hours 1
Once-daily regimen: 12 mL every 24 hours 1
Cefdinir may be administered without regard to meals 1
The suspension should be shaken well before each administration and can be stored at room temperature for 10 days after mixing 1
Clinical Efficacy Considerations
- Cefdinir demonstrates excellent activity against common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 2, 3
- The drug is stable against hydrolysis by commonly occurring plasmid-mediated beta-lactamases, maintaining activity against beta-lactamase-producing strains 3
- Clinical cure rates of approximately 90-98% have been demonstrated in pediatric patients with respiratory tract and skin infections 4, 5
Safety Profile
- Diarrhea is the most common adverse event, occurring in approximately 8% of pediatric patients 5
- The oral suspension has demonstrated superior taste and palatability compared to other oral antimicrobial agents 2
- Treatment discontinuation rates due to adverse events are generally low and similar to comparator agents 3, 6
Important Caveats
Renal insufficiency: For pediatric patients with creatinine clearance <30 mL/min/1.73 m², reduce the dose to 7 mg/kg (up to 300 mg) once daily 1
Hemodialysis patients: Administer 7 mg/kg every other day, with an additional dose after each dialysis session 1