Cefdinir Dosing for 25-Pound Pediatric Patient
For a 25-pound (11.3 kg) pediatric patient, administer cefdinir 7 mg/kg every 12 hours OR 14 mg/kg once daily, which translates to approximately 80 mg (or 2 mL of 125 mg/5 mL suspension) twice daily OR 160 mg (or 3.2 mL of 250 mg/5 mL suspension) once daily. 1
Standard Dosing Algorithm
The FDA-approved dosing for pediatric patients aged 6 months through 12 years is straightforward 1:
- Total daily dose: 14 mg/kg/day (maximum 600 mg/day)
- Dosing frequency options:
- 7 mg/kg every 12 hours (twice daily), OR
- 14 mg/kg every 24 hours (once daily)
Specific Calculation for 25-Pound Patient
For a patient weighing 25 pounds (11.3 kg):
Twice-daily regimen: 7 mg/kg × 11.3 kg = 79 mg per dose
- Using 125 mg/5 mL suspension: 2 mL every 12 hours 1
Once-daily regimen: 14 mg/kg × 11.3 kg = 158 mg per dose
- Using 250 mg/5 mL suspension: 3.2 mL every 24 hours 1
Indication-Specific Considerations
Duration varies by infection type 1:
- Acute otitis media: 5-10 days (once-daily dosing) or 10 days (twice-daily dosing)
- Acute maxillary sinusitis: 10 days
- Pharyngitis/tonsillitis: 5-10 days (once-daily) or 10 days (twice-daily)
- Skin infections: 10 days (must use twice-daily dosing; once-daily not studied for this indication) 1
Administration Guidelines
- May be given without regard to meals 1
- Shake suspension well before each dose 1
- Discard unused suspension after 10 days 1
- The oral suspension has demonstrated superior palatability compared to other oral antimicrobials, which may improve adherence 2
Critical Pitfall to Avoid
For uncomplicated skin and skin structure infections, you must use the twice-daily regimen (7 mg/kg every 12 hours) because once-daily dosing has not been studied for this indication 1. Using once-daily dosing for skin infections would be off-label and potentially suboptimal.
Efficacy Considerations
Cefdinir provides excellent coverage against common community-acquired pathogens including beta-lactamase-producing Haemophilus influenzae and Moraxella catarrhalis, as well as penicillin-susceptible Streptococcus pneumoniae 2, 3. However, efficacy decreases significantly against penicillin-resistant S. pneumoniae, with eradication rates dropping to only 43% for highly resistant strains 4. If penicillin-resistant pneumococcus is suspected, consider alternative agents.