Cefdinir Dosing for a 10-Year-Old Weighing 60.1 kg
For a 10-year-old child weighing 60.1 kg with normal renal function, administer cefdinir 300 mg twice daily (or 600 mg once daily for most infections except skin infections, which require twice-daily dosing). 1
Weight-Based Dosing Algorithm
Since this child weighs 60.1 kg (≥43 kg), they have exceeded the pediatric weight threshold and should receive the maximum daily dose of 600 mg per day. 1
- For twice-daily dosing: 300 mg every 12 hours 1
- For once-daily dosing: 600 mg every 24 hours (except for skin infections) 1
The FDA labeling explicitly states that pediatric patients who weigh ≥43 kg should receive the maximum daily dose of 600 mg, which is equivalent to the standard adult dose. 1
Infection-Specific Considerations
Duration and frequency depend on the type of infection:
- Acute bacterial otitis media: 7 mg/kg every 12 hours OR 14 mg/kg every 24 hours for 5-10 days 1
- Acute maxillary sinusitis: 7 mg/kg every 12 hours OR 14 mg/kg every 24 hours for 10 days 1
- Pharyngitis/tonsillitis: 7 mg/kg every 12 hours OR 14 mg/kg every 24 hours for 5-10 days 1
- Uncomplicated skin and skin structure infections: 7 mg/kg every 12 hours (twice-daily dosing only) for 10 days 1
Critical caveat: Once-daily dosing has not been studied in skin infections, so cefdinir must be administered twice daily for these conditions. 1
Practical Administration
At 60.1 kg, this patient can receive:
- Capsule formulation: 300 mg capsules twice daily (or 600 mg once daily for appropriate infections) 1
- Oral suspension: If using the 250 mg/5 mL suspension, administer 6 mL every 12 hours or 12 mL every 24 hours 1
Cefdinir may be administered without regard to meals. 1
Renal Function Considerations
No dose adjustment is needed for this patient assuming normal renal function. 1
Dose reduction is only required if creatinine clearance is <30 mL/min, in which case the dose should be reduced to 7 mg/kg (up to 300 mg) once daily. 1
Common Pitfalls to Avoid
- Do not underdose: At 60.1 kg, this child requires the full adult dose of 600 mg daily, not a reduced pediatric dose. 1
- Do not use once-daily dosing for skin infections: These require twice-daily administration regardless of weight. 1
- Warn about red stools: If the patient is taking iron-containing supplements or formulas, cefdinir can form a nonabsorbable complex with ferric ions, causing harmless reddish stools that may be mistaken for gastrointestinal bleeding. 2
- Monitor for diarrhea: This is the most common adverse event, occurring in approximately 20% of patients, though it is typically mild. 3
Clinical Efficacy Context
Cefdinir demonstrates excellent activity against common respiratory and skin pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, with stability against beta-lactamase-producing strains. 4, 5 Clinical trials have shown approximately 90% cure rates for community-acquired infections with good tolerability. 3