Cefdinir Dosing for Bacterial Infections
For adults and adolescents with bacterial infections, administer cefdinir 300 mg orally twice daily or 600 mg once daily for 5-10 days depending on the infection type; for pediatric patients (6 months-12 years), use 7 mg/kg every 12 hours or 14 mg/kg once daily (maximum 600 mg/day), with dose adjustments required for renal impairment. 1
Adult and Adolescent Dosing
Standard Dosing (Normal Renal Function)
- 300 mg orally twice daily OR 600 mg once daily for most infections 1, 2
- Duration: 5-10 days depending on infection type 1
- May be administered without regard to meals 1
Renal Impairment Adjustments
For creatinine clearance <30 mL/min:
- Reduce dose to 300 mg once daily 1
- Use the Cockcroft-Gault formula to estimate creatinine clearance in adults 1:
- Males: CLcr = (weight × [140 - age]) / (72 × serum creatinine)
- Females: CLcr = 0.85 × above value 1
For hemodialysis patients:
- Initial dose: 300 mg every other day 1
- At conclusion of each hemodialysis session: give 300 mg 1
- Subsequent doses: 300 mg every other day 1
- Note: Approximately 60% of cefdinir is removed by 3-4 hours of hemodialysis 3
Pediatric Dosing (Age 6 Months Through 12 Years)
Standard Dosing by Infection Type
Total daily dose: 14 mg/kg (maximum 600 mg/day) 1
| Infection Type | Dosing Regimen | Duration |
|---|---|---|
| Acute otitis media | 7 mg/kg q12h OR 14 mg/kg q24h | 5-10 days (once daily) or 10 days (twice daily) [1] |
| Acute sinusitis | 7 mg/kg q12h OR 14 mg/kg q24h | 10 days [1] |
| Pharyngitis/tonsillitis | 7 mg/kg q12h OR 14 mg/kg q24h | 5-10 days (once daily) or 10 days (twice daily) [1] |
| Skin/skin structure infections | 7 mg/kg q12h only | 10 days [1] |
Important caveat: Once-daily dosing has NOT been studied for skin infections, so twice-daily dosing must be used for this indication 1
Weight-Based Dosing Chart
For pediatric patients ≥43 kg: use maximum adult dose of 600 mg/day 1
Using 125 mg/5 mL suspension:
- 9 kg (20 lbs): 2.5 mL q12h or 5 mL q24h 1
- 18 kg (40 lbs): 5 mL q12h or 10 mL q24h 1
- 27 kg (60 lbs): 7.5 mL q12h or 15 mL q24h 1
- 36 kg (80 lbs): 10 mL q12h or 20 mL q24h 1
Using 250 mg/5 mL suspension:
- 18 kg (40 lbs): 2.5 mL q12h or 5 mL q24h 1
- 27 kg (60 lbs): 3.75 mL q12h or 7.5 mL q24h 1
- 36 kg (80 lbs): 5 mL q12h or 10 mL q24h 1
Pediatric Renal Impairment
For creatinine clearance <30 mL/min/1.73 m²:
- Reduce dose to 7 mg/kg once daily (maximum 300 mg) 1
- Use modified Schwartz formula to estimate pediatric creatinine clearance 1:
For pediatric hemodialysis patients:
- 7 mg/kg every other day 1
- At conclusion of each hemodialysis session: give 7 mg/kg 1
- Subsequent doses: 7 mg/kg every other day 1
Clinical Considerations
Antimicrobial Spectrum
- Excellent activity against common respiratory pathogens: Streptococcus pneumoniae (penicillin-susceptible), Haemophilus influenzae, and Moraxella catarrhalis 2, 4
- Stable to hydrolysis by common plasmid-mediated beta-lactamases 4, 5
- Particularly useful in areas with elevated beta-lactamase production rates 2
Safety Profile
- Most common adverse event: mild diarrhea (approximately 20% of patients) 6
- Generally well tolerated across all age groups 4
- Discontinuation rates due to adverse events similar to comparator agents 4
- Superior taste/palatability of oral suspension compared to other antimicrobials 2
Important Caveats
- Antibiotic stewardship: Minimize frequency and duration of cephalosporin use to reduce Clostridioides difficile infection risk 7
- Discontinue inciting antibiotics as soon as possible when CDI is suspected 7
- Suspension stable for 10 days after reconstitution at room temperature; discard unused portion after this period 1
- Pharmacokinetic parameters in children similar to adults when using equivalent mg/m² doses 5