Cefixime (Taxim-O) Dosing for a 4-Year-Old Child Weighing 13 kg
For a 4-year-old child weighing 13 kg, administer cefixime 8 mg/kg/day, which equals approximately 104 mg daily, given as 5 mL once daily or 2.5 mL twice daily using the standard 100 mg/5 mL suspension formulation.
Weight-Based Calculation
- The standard pediatric dose of cefixime is 8 mg/kg/day, which can be administered as a single daily dose or divided into two doses 1, 2
- For a 13 kg child: 13 kg × 8 mg/kg = 104 mg per day 1
- Using the typical 100 mg/5 mL suspension: this translates to approximately 5 mL once daily or 2.5 mL twice daily 1, 2
Dosing Schedule Options
- Once-daily dosing (preferred): The 3-4 hour elimination half-life and sustained serum concentrations above MIC90 for susceptible pathogens permit once-daily administration, which improves adherence 1, 2
- Twice-daily dosing (alternative): Dividing the daily dose into two administrations (2.5 mL twice daily) may reduce gastrointestinal adverse effects, particularly diarrhea, which occurs more frequently with once-daily dosing 3
Clinical Context and Indications
- Cefixime provides excellent coverage against common pediatric respiratory pathogens including Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis 2
- It demonstrates superior activity against beta-lactamase-producing strains compared to first- and second-generation cephalosporins 1, 4, 2
- The Infectious Diseases Society of America guidelines list cefixime as an acceptable alternative for oral step-down therapy in respiratory infections, though it is not first-line therapy 5
Treatment Duration
- For respiratory tract infections including acute otitis media and lower respiratory infections, the typical treatment course is 5-7 days 1, 2
- Clinical improvement should be evident within 48-72 hours; if no improvement occurs, reevaluation is necessary 6
Important Caveats
- Gastrointestinal effects: Diarrhea and stool changes are the most common adverse effects, usually mild to moderate, transient, and occurring in the first few days of treatment 1
- Limited activity: Cefixime has minimal activity against Staphylococcus aureus and no activity against Pseudomonas aeruginosa 1, 4
- Not first-line for pneumonia: High-dose amoxicillin (90 mg/kg/day) remains superior for community-acquired pneumonia, particularly in areas with penicillin-resistant Streptococcus pneumoniae 5, 6
- Cefixime should be reserved for situations where first-line agents (amoxicillin or amoxicillin-clavulanate) have failed, are contraindicated due to allergy, or when beta-lactamase-producing organisms are suspected 5