Cefdinir Dosing for an 11-Year-Old Child Weighing 44kg
For an 11-year-old child weighing 44kg taking cefdinir once daily, the recommended dose is 600 mg once daily (14 mg/kg/day), which is the maximum daily dose for pediatric patients. 1
Weight-Based Dosing Calculation
- The FDA-approved dosing for pediatric patients aged 6 months through 12 years is 14 mg/kg once daily (or 7 mg/kg twice daily) 1
- For this 44kg child: 14 mg/kg × 44kg = 616 mg/day
- However, the maximum daily dose is capped at 600 mg/day regardless of weight calculation 1
- Pediatric patients weighing ≥43kg should receive the maximum daily dose of 600 mg 1
Practical Administration
- Using 250 mg/5 mL suspension: administer 12 mL once daily 1
- Using 125 mg/5 mL suspension: administer 24 mL once daily 1
- Cefdinir may be administered without regard to meals 1
Clinical Context and Positioning
- Cefdinir is positioned as an alternative agent, not first-line therapy, for most pediatric respiratory infections 2
- The Infectious Diseases Society of America lists cefdinir alongside cefixime, cefpodoxime, and ceftibuten as alternatives when amoxicillin-clavulanate cannot be used for pediatric pneumonia, particularly for β-lactamase-producing Haemophilus influenzae 3, 2
- High-dose amoxicillin (90 mg/kg/day) remains superior for resistant pneumococcal infections 2
Indication-Specific Duration
According to FDA labeling, once-daily dosing duration varies by indication 1:
- Acute bacterial otitis media: 10 days
- Acute maxillary sinusitis: 10 days
- Pharyngitis/tonsillitis: 10 days
- Note: Once-daily dosing has not been studied for skin infections; twice-daily dosing should be used for uncomplicated skin and skin structure infections 1
Important Caveats
- Once-daily dosing is only appropriate for specific indications (otitis media, sinusitis, pharyngitis/tonsillitis) and should not be used for skin infections 1
- Cefdinir has good activity against β-lactamase-producing H. influenzae and M. catarrhalis, but effectiveness is markedly decreased against penicillin-nonsusceptible S. pneumoniae 4
- In high-risk AOM patients, large-dose cefdinir (25 mg/kg once daily) showed only 43% eradication of penicillin-resistant S. pneumoniae compared to 91% for penicillin-susceptible strains 4