What dose of cefdinir suspension (250 mg per 5 mL) should be given per administration to a 59‑lb (≈27 kg) child?

Cefdinir Dosing for a 59-lb (27 kg) Child

For a 59-lb (approximately 27 kg) child, give 7.5 mL of cefdinir 250 mg/5 mL suspension twice daily (every 12 hours), or 15 mL once daily (every 24 hours), depending on the infection being treated. 1

Weight-Based Calculation

• A 59-lb child weighs approximately 27 kg, which falls into the "27 kg/60 lbs" category in the FDA dosing chart. 1
• The total daily dose for all infections in pediatric patients is 14 mg/kg, up to a maximum of 600 mg per day. 1
• For this 27 kg child: 14 mg/kg × 27 kg = 378 mg total daily dose. 1

Specific Dosing by Suspension Concentration

Using 250 mg/5 mL Suspension (Preferred for This Weight)

• Twice-daily dosing: 3.75 mL every 12 hours 1
• Once-daily dosing: 7.5 mL every 24 hours 1

Using 125 mg/5 mL Suspension (Alternative)

• Twice-daily dosing: 7.5 mL every 12 hours 1
• Once-daily dosing: 15 mL every 24 hours 1

Infection-Specific Dosing Schedules

Once-Daily Dosing (14 mg/kg every 24 hours for 10 days)

• Acute bacterial otitis media 1
• Acute maxillary sinusitis 1
• Pharyngitis/tonsillitis 1
• Once-daily dosing for 10 days is as effective as twice-daily dosing for these infections. 1

Twice-Daily Dosing Required (7 mg/kg every 12 hours for 10 days)

• Uncomplicated skin and skin structure infections – once-daily dosing has not been studied for skin infections, so twice-daily administration is mandatory. 1

Flexible Duration Options

• Acute bacterial otitis media may be treated for 5 to 10 days with either once- or twice-daily dosing. 1
• Pharyngitis/tonsillitis may be treated for 5 to 10 days with either once- or twice-daily dosing. 1

Administration Guidelines

• Cefdinir suspension may be administered without regard to meals. 1
• After mixing, store the suspension at room temperature (25°C/77°F) in a tightly closed container. 1
• Shake well before each administration. 1
• The suspension may be used for 10 days after mixing, after which any unused portion must be discarded. 1

Clinical Efficacy Evidence

• Cefdinir provides good coverage against Haemophilus influenzae, Moraxella catarrhalis, and penicillin-susceptible Streptococcus pneumoniae, the most common respiratory tract pathogens. 2
• The drug is stable to hydrolysis by commonly occurring plasmid-mediated beta-lactamases and retains good activity against beta-lactamase-producing strains. 2
• Clinical trials demonstrate efficacy rates of 88.5–94% in pediatric patients with respiratory tract, middle ear, and skin infections. 3, 4

Common Pitfalls to Avoid

• Do not use once-daily dosing for skin infections – this has not been studied and twice-daily dosing is required. 1
• Verify the suspension concentration (125 mg/5 mL vs. 250 mg/5 mL) before calculating the volume to avoid dosing errors. 1
• Do not exceed 600 mg total daily dose regardless of weight-based calculation. 1
• Diarrhea is the most common adverse event; discontinue if severe. 2