Cefdinir Dosing for a 38-Pound Pediatric Patient
For a 38-pound (17.3 kg) pediatric patient, administer cefdinir 7 mg/kg every 12 hours OR 14 mg/kg once daily (total daily dose 14 mg/kg), which equals approximately 120 mg every 12 hours or 240 mg once daily, using the 250 mg/5 mL suspension. 1
Weight-Based Calculation
- Patient weight: 38 pounds = 17.3 kg
- Standard pediatric dosing: 14 mg/kg/day total daily dose 1
- Calculated dose: 17.3 kg × 14 mg/kg = 242 mg/day 1
Practical Dosing Options
Using the 250 mg/5 mL suspension concentration:
Option 1: Twice-Daily Dosing
- 7 mg/kg every 12 hours = approximately 120 mg per dose 1
- Volume: 2.5 mL every 12 hours (provides 125 mg per dose) 1
- This slightly exceeds the calculated dose but falls within the FDA-approved dosing chart 1
Option 2: Once-Daily Dosing
- 14 mg/kg once daily = approximately 240 mg per dose 1
- Volume: 5 mL once daily (provides 250 mg) 1
- Once-daily dosing is as effective as twice-daily dosing for most infections 1
Indication-Specific Considerations
For acute otitis media, sinusitis, or pharyngitis/tonsillitis:
- Either 2.5 mL every 12 hours OR 5 mL once daily for 5-10 days 1
- Once-daily dosing has been specifically studied and proven effective for these indications 1, 2
For uncomplicated skin and skin structure infections:
- Must use twice-daily dosing: 2.5 mL every 12 hours for 10 days 1
- Once-daily dosing has NOT been studied for skin infections 1
Administration Guidelines
- Cefdinir may be administered without regard to meals 1
- Shake suspension well before each administration 1
- Suspension remains stable for 10 days after mixing at room temperature 1
Common Pitfalls to Avoid
- Do not use once-daily dosing for skin infections — the FDA label explicitly states this has not been studied, and twice-daily dosing is required 1
- Do not exceed 600 mg total daily dose regardless of weight-based calculations 1
- Be aware that diarrhea is the most common adverse event, occurring more frequently than with some comparator agents 3, 4
- Ensure adequate renal function; dose adjustment required if creatinine clearance <30 mL/min/1.73 m² 1
Practical Recommendation Summary
For this 38-pound patient, prescribe cefdinir 250 mg/5 mL suspension, 2.5 mL every 12 hours for respiratory infections (with option to use 5 mL once daily), or 2.5 mL every 12 hours for skin infections (twice-daily mandatory). 1