Cefdinir Dosing for an 8-Year-Old Female Weighing 98 Pounds
For this 8-year-old patient weighing 98 pounds (44.5 kg), administer cefdinir 14 mg/kg/day, which equals 600 mg daily (the maximum daily dose), given either as 300 mg twice daily or 600 mg once daily for most infections. 1
Weight-Based Calculation
- This patient weighs approximately 44.5 kg, which exceeds the 43 kg threshold where the maximum daily dose of 600 mg applies regardless of calculated weight-based dosing 1
- The FDA-approved dosing for pediatric patients aged 6 months through 12 years is 14 mg/kg/day, up to a maximum of 600 mg per day 1
- For patients ≥43 kg, the dosage chart specifies 12 mL twice daily or 24 mL once daily of the 125 mg/5 mL suspension, or 6 mL twice daily or 12 mL once daily of the 250 mg/5 mL suspension 1
Dosing Regimen Options
- Once-daily dosing (600 mg): This regimen has been proven as effective as twice-daily dosing for 10-day treatment courses in respiratory tract infections 1, 2
- Twice-daily dosing (300 mg every 12 hours): This is required for uncomplicated skin and skin structure infections, as once-daily dosing has not been studied for these infections 1
Infection-Specific Duration
- Acute bacterial otitis media: 5 to 10 days with either once- or twice-daily dosing 1
- Acute maxillary sinusitis: 10 days with either once- or twice-daily dosing 1
- Pharyngitis/tonsillitis: 5 to 10 days with either once- or twice-daily dosing 1
- Uncomplicated skin infections: 10 days with twice-daily dosing only 1
Administration Considerations
- Cefdinir may be administered without regard to meals, though taking it with food may improve gastrointestinal tolerability 1, 3
- The oral suspension should be shaken well before each dose and can be stored at room temperature for up to 10 days after reconstitution 1
Critical Pitfalls to Avoid
- Do not exceed 600 mg daily: Even though weight-based calculation (14 mg/kg × 44.5 kg = 623 mg) would suggest a higher dose, the FDA-approved maximum is 600 mg per day for pediatric patients 1
- Avoid iron-containing products: Cefdinir forms a nonabsorbable complex with ferric ions that can cause harmless but alarming red-colored stools; separate administration of iron supplements or iron-fortified formulas by at least 2 hours 4
- Do not use once-daily dosing for skin infections: Once-daily administration has only been validated for respiratory tract infections 1
- Adjust for renal impairment: If creatinine clearance is <30 mL/min/1.73 m², reduce the dose to 7 mg/kg (up to 300 mg) once daily 1