Cefdinir Liquid Dosing for 54 kg 12-Year-Old
For a 12-year-old weighing 54 kg, administer cefdinir 300 mg (6 mL of the 250 mg/5 mL suspension) twice daily for most infections, as this patient exceeds the 43 kg threshold where the maximum adult dose of 600 mg/day applies. 1
Weight-Based Dosing Threshold
- Pediatric patients weighing ≥43 kg should receive the maximum daily dose of 600 mg, which translates to 300 mg twice daily or 600 mg once daily depending on the infection type 1
- At 54 kg, this patient has crossed into the maximum dosing category, so weight-based calculations (14 mg/kg/day = 756 mg/day) are capped at the 600 mg/day maximum 1
Practical Liquid Formulation Dosing
Using the 250 mg/5 mL suspension (the higher concentration for easier administration):
- Give 6 mL twice daily (every 12 hours) for skin infections, acute otitis media, sinusitis, or pharyngitis 1
- Give 12 mL once daily for acute otitis media, sinusitis, or pharyngitis (but NOT for skin infections, which require twice-daily dosing) 1
Using the 125 mg/5 mL suspension (if 250 mg/5 mL unavailable):
- Give 12 mL twice daily or 24 mL once daily (depending on infection type) 1
Infection-Specific Considerations
- For skin and skin structure infections: Must use twice-daily dosing (7 mg/kg every 12 hours) for 10 days, as once-daily dosing has not been studied for this indication 1
- For acute otitis media, sinusitis, or pharyngitis: Either twice-daily or once-daily dosing is acceptable, with once-daily shown to be as effective as twice-daily for these infections 1
- Treatment duration: 5-10 days for most respiratory infections, 10 days for skin infections 1
Clinical Context for Cefdinir Use
- Cefdinir is listed as an alternative oral cephalosporin for children with non-Type 1 penicillin allergies or when treating β-lactamase-producing Haemophilus influenzae 2, 3
- Amoxicillin remains the preferred first-line agent for most pediatric respiratory infections, with cefdinir reserved for specific scenarios (β-lactamase producers, penicillin allergy) 3, 4
- Cefdinir demonstrates excellent activity against Staphylococcus aureus and has superior palatability compared to other oral suspensions, improving adherence 5, 6
Important Caveats
- Administer without regard to meals for optimal convenience 1
- Shake suspension well before each dose and discard any unused portion after 10 days 1
- For patients with renal insufficiency (creatinine clearance <30 mL/min/1.73 m²), reduce dose to 7 mg/kg once daily 1
- Common adverse effects include diarrhea (8% incidence in pediatric studies), which is generally mild 6