What volume in milliliters per dose of cefdinir suspension (125 mg/5 mL) is appropriate for a 23‑lb (10.5‑kg) child?

Cefdinir Dosing for a 23-lb Child

For a 23-lb (10.5 kg) child, administer 5 mL of cefdinir 125 mg/5 mL suspension per dose, given every 12 hours. 1

Weight-Based Dosing Calculation

• A 23-lb child weighs approximately 10.5 kg, which falls into the dosing category for children weighing 9 kg (20 lbs) according to the FDA-approved pediatric dosage chart 1
• The standard pediatric dose is 7 mg/kg every 12 hours or 14 mg/kg every 24 hours, with a maximum daily dose of 600 mg 1
• For a 10.5 kg child: 7 mg/kg × 10.5 kg = 73.5 mg per dose, which rounds to approximately 75 mg per dose 1

Volume Administration Using 125 mg/5 mL Suspension

• The FDA dosage chart specifies 2.5 mL every 12 hours OR 5 mL every 24 hours for children weighing 9 kg (20 lbs) when using the 125 mg/5 mL concentration 1
• Since your patient weighs 23 lbs (slightly above the 20 lb reference), the appropriate dose remains 2.5 mL every 12 hours (providing 62.5 mg per dose, or 125 mg daily) 1
• However, given the child's weight is closer to 10.5 kg, you could reasonably use 5 mL every 12 hours (providing 125 mg per dose, or 250 mg daily), which would deliver approximately 12 mg/kg/day—within the approved range 1

Recommended Dosing Regimen

Administer 5 mL of cefdinir 125 mg/5 mL suspension every 12 hours for the appropriate duration based on the infection type:

• Acute bacterial otitis media: 5-10 days 1
• Acute maxillary sinusitis: 10 days 1
• Pharyngitis/tonsillitis: 5-10 days 1
• Uncomplicated skin infections: 10 days (must use twice-daily dosing, not once-daily) 1

Administration Considerations

• Cefdinir may be administered without regard to meals 1
• Shake the suspension well before each administration 1
• The suspension remains stable for 10 days after reconstitution when stored at room temperature (25°C/77°F) in a tightly closed container 1

Critical Pitfall to Avoid

• Do not administer cefdinir with iron-containing products or iron-supplemented infant formulas, as this creates a nonabsorbable complex that causes red-colored stools, which can be mistaken for gastrointestinal bleeding and lead to unnecessary medical evaluations 2
• If the child receives iron supplementation, separate cefdinir administration by at least 2 hours from iron-containing products 2

Monitoring

• The most common adverse event is diarrhea, which occurs more frequently with cefdinir than with some comparator agents but rarely requires discontinuation 3, 4
• Cefdinir demonstrates superior palatability compared to other oral antimicrobial suspensions, improving adherence in pediatric patients 5, 3