What is the recommended dose of Omnicef (cefdinir) for an 11-year-old patient weighing 120 pounds?

Omnicef Dosing for an 11-Year-Old Weighing 120 lbs

For an 11-year-old weighing 120 lbs (54.5 kg), the recommended dose of Omnicef (cefdinir) is 300 mg twice daily (600 mg total daily dose) for most infections, or 600 mg once daily as an alternative for certain indications. 1

Weight-Based Dosing Calculation

• This patient weighs 54.5 kg, which exceeds the 43 kg threshold where pediatric patients should receive the maximum adult daily dose of 600 mg per day 1
• The standard pediatric dosing is 14 mg/kg/day (up to maximum 600 mg/day), which can be administered as:
  • 7 mg/kg every 12 hours (twice daily), OR
  • 14 mg/kg every 24 hours (once daily) 1
• For this 54.5 kg patient, the calculated dose would be 763 mg/day, but this is capped at the maximum of 600 mg/day 1

Dosing Regimen by Indication

The specific dosing schedule depends on the type of infection:

• Acute bacterial otitis media: 300 mg twice daily for 5-10 days, OR 600 mg once daily for 10 days 1
• Acute maxillary sinusitis: 300 mg twice daily for 10 days, OR 600 mg once daily for 10 days 1
• Pharyngitis/tonsillitis: 300 mg twice daily for 5-10 days, OR 600 mg once daily for 10 days 1
• Uncomplicated skin and skin structure infections: 300 mg twice daily for 10 days (once-daily dosing has not been studied for skin infections) 1

Administration Instructions

• Cefdinir may be administered without regard to meals, though taking it with food may improve gastrointestinal tolerability 1
• The medication is available as 300 mg capsules for patients of this age and weight 1
• For twice-daily dosing: Give one 300 mg capsule every 12 hours 1
• For once-daily dosing (when appropriate): Give two 300 mg capsules (600 mg total) every 24 hours 1

Clinical Efficacy Considerations

• Cefdinir demonstrates good clinical and bacteriological efficacy against common respiratory and skin pathogens when dosed at 600 mg daily in adults and adolescents 2
• The drug achieves excellent tissue penetration in respiratory tract tissues, fluids, skin blisters, and ear fluids 2
• Clinical cure rates of approximately 90% have been demonstrated for community-acquired respiratory infections and skin infections 3

Important Caveats

• Renal insufficiency: If creatinine clearance is <30 mL/min, reduce dose to 300 mg once daily 1
• Hemodialysis patients: Give 300 mg every other day, with an additional 300 mg dose after each dialysis session 1
• The most common adverse effect is mild diarrhea, occurring in approximately 20% of patients 3
• Once-daily dosing should NOT be used for skin and skin structure infections due to lack of supporting clinical data 1