Cefdinir Dosing for a 52-Pound Child
Recommended Dose
For a child weighing 52 pounds (23.6 kg), administer cefdinir 7 mg/kg every 12 hours using the 250 mg/5 mL suspension, which equals 5 mL (250 mg) twice daily. 1
Weight-Based Dosing Algorithm
A 52-pound child falls into the dosing category for children weighing approximately 40-60 pounds (18-27 kg) 1:
- Using 250 mg/5 mL suspension: 2.5 mL every 12 hours for children weighing 18 kg (40 lbs), escalating to 3.75 mL every 12 hours for 27 kg (60 lbs) 1
- For 52 pounds (23.6 kg): The appropriate dose is approximately 5 mL of the 250 mg/5 mL suspension (250 mg) every 12 hours 1
- Total daily dose: 14 mg/kg/day divided into two doses, not to exceed 600 mg per day 1
Dosing by Indication
The duration varies by infection type 1:
- Acute bacterial otitis media: 7 mg/kg every 12 hours for 5-10 days 1
- Acute maxillary sinusitis: 7 mg/kg every 12 hours for 10 days 1
- Pharyngitis/tonsillitis: 7 mg/kg every 12 hours for 5-10 days 1
- Uncomplicated skin infections: 7 mg/kg every 12 hours for 10 days (must use twice-daily dosing, not once-daily) 1
Alternative Once-Daily Dosing
For certain infections (excluding skin infections), once-daily dosing may be used 1:
- 14 mg/kg once daily (maximum 600 mg) has been studied for otitis media, sinusitis, and pharyngitis 1
- For this 52-pound child: 10 mL of 250 mg/5 mL suspension (500 mg) once daily 1
- Once-daily dosing has NOT been studied for skin infections and should not be used 1
Critical Pitfalls to Avoid
- Do not use the 125 mg/5 mL suspension for this weight: The dosing chart indicates children ≥18 kg (40 lbs) should use the 250 mg/5 mL formulation for practical administration 1
- Shake suspension well before each dose: Failure to shake adequately results in inconsistent dosing 1
- Administer without regard to meals: Food does not significantly affect absorption 1
- Discard unused suspension after 10 days: The reconstituted suspension is only stable for 10 days at room temperature 1
Special Considerations
Iron interaction: If the child receives iron-supplemented formula or iron supplements, cefdinir may cause harmless red-colored stools due to formation of a nonabsorbable cefdinir-iron complex 2. This is not gastrointestinal bleeding and resolves upon drug discontinuation 2.
Renal function: No dose adjustment is needed unless creatinine clearance is <30 mL/min/1.73 m², in which case reduce to 7 mg/kg once daily 1.
Clinical Efficacy
Cefdinir demonstrates excellent activity against common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, with stability against beta-lactamase-producing strains 3, 4. In pediatric streptococcal pharyngitis trials, cefdinir achieved superior bacteriologic eradication rates (92.7%) compared to penicillin V (70.9%, P<0.001) 5.