Cefdinir Dosing for an 18-Month-Old Child
For an 18-month-old child with normal renal function, administer cefdinir 14 mg/kg/day divided into either 7 mg/kg every 12 hours or 14 mg/kg once daily, using the 125 mg/5 mL or 250 mg/5 mL oral suspension concentration. 1
Standard Dosing Regimen
The FDA-approved dosing for pediatric patients aged 6 months through 12 years is straightforward:
- Total daily dose: 14 mg/kg/day (maximum 600 mg/day) 1
- Dosing frequency options:
- 7 mg/kg every 12 hours, OR
- 14 mg/kg once daily 1
Once-daily dosing is as effective as twice-daily dosing for most indications (acute otitis media, sinusitis, pharyngitis/tonsillitis), with the important exception of skin infections, which require twice-daily administration. 1
Available Concentrations and Practical Dosing
Cefdinir oral suspension comes in two concentrations 1:
- 125 mg/5 mL (25 mg/mL)
- 250 mg/5 mL (50 mg/mL)
Weight-Based Dosing Chart
For an 18-month-old, typical weights range from 9-12 kg. Using the FDA dosing chart 1:
- 9 kg child: 2.5 mL of 125 mg/5 mL suspension every 12 hours OR 5 mL once daily
- 10-11 kg child: Approximately 2.8-3 mL of 125 mg/5 mL every 12 hours OR 5.5-6 mL once daily
- 12 kg child: 3.4 mL of 125 mg/5 mL every 12 hours OR 6.7 mL once daily
The 250 mg/5 mL concentration allows for smaller volumes (half the volume of the 125 mg/5 mL product for the same dose), which may improve compliance in young children. 1
Duration of Therapy by Indication
- Acute otitis media: 5-10 days (once-daily dosing: 10 days) 1
- Acute sinusitis: 10 days 1
- Pharyngitis/tonsillitis: 5-10 days (once-daily dosing: 10 days) 1
- Skin infections: 10 days (must use twice-daily dosing) 1
Important Clinical Considerations
Cefdinir can be administered without regard to meals, which provides flexibility in dosing schedules for young children. 1
The suspension remains stable for 10 days after reconstitution when stored at room temperature (25°C/77°F); any unused portion must be discarded after this period. 1
Palatability Advantage
Cefdinir oral suspension has demonstrated superior taste and palatability compared to other oral antimicrobial agents in pediatric studies, which is particularly important for medication adherence in toddlers. 2
Renal Impairment Adjustment
For pediatric patients with creatinine clearance <30 mL/min/1.73 m², reduce the dose to 7 mg/kg (up to 300 mg) once daily. 1 This is unlikely to apply to a healthy 18-month-old but should be considered if renal dysfunction is present.
Common Pitfall to Avoid
Do not use higher doses (e.g., 25 mg/kg/day) in an attempt to cover penicillin-resistant Streptococcus pneumoniae. Research has shown that even 25 mg/kg once daily is ineffective against penicillin-nonsusceptible S. pneumoniae and is associated with a 20% incidence of diarrhea. 3 The standard 14 mg/kg/day dose is appropriate for penicillin-susceptible strains only. 1, 3