Cefdinir Dosing for a 36-Pound Child
For a 36-pound (16.3 kg) child, administer cefdinir 5 mL of the 250 mg/5 mL suspension twice daily (every 12 hours) or 10 mL once daily (every 24 hours), providing a total daily dose of 14 mg/kg. 1
Weight-Based Dosing Calculation
The FDA-approved pediatric dosing for cefdinir is 14 mg/kg per day, which can be administered as either 7 mg/kg every 12 hours or 14 mg/kg every 24 hours (maximum 600 mg/day). 1
For a child weighing 36 pounds (16.3 kg), the calculated daily dose is approximately 228 mg per day (16.3 kg × 14 mg/kg). 1
Using the 250 mg/5 mL suspension, this translates to:
- Twice-daily regimen: 5 mL every 12 hours (250 mg/day total)
- Once-daily regimen: 10 mL every 24 hours (500 mg/day total) 1
Dosing Frequency Considerations
Once-daily dosing (14 mg/kg every 24 hours) is as effective as twice-daily dosing (7 mg/kg every 12 hours) for most indications, including acute otitis media, sinusitis, and pharyngitis/tonsillitis, and may improve adherence. 1, 2
For uncomplicated skin and skin structure infections, cefdinir should be administered twice daily because once-daily dosing has not been studied in this indication. 1
Treatment Duration by Indication
- Acute bacterial otitis media: 5–10 days (twice daily) or 10 days (once daily) 1
- Acute maxillary sinusitis: 10 days (either regimen) 1
- Pharyngitis/tonsillitis: 5–10 days (twice daily) or 10 days (once daily) 1
- Uncomplicated skin infections: 10 days (twice daily only) 1
Clinical Context and Rationale
Cefdinir is an alternative oral cephalosporin recommended by the Infectious Diseases Society of America for β-lactamase-producing Haemophilus influenzae when amoxicillin or amoxicillin-clavulanate cannot be used. 3
The drug provides excellent coverage against common respiratory pathogens, including β-lactamase-producing H. influenzae and Moraxella catarrhalis, as well as penicillin-susceptible Streptococcus pneumoniae. 2, 4, 5
Cefdinir distributes well into respiratory tissues, middle ear fluid, and skin, supporting its use in community-acquired infections. 2, 5
Administration Guidelines
Cefdinir suspension may be administered without regard to meals. 1
After reconstitution, the suspension should be stored at room temperature (25°C/77°F) in a tightly closed container and shaken well before each dose. 1
The suspension may be used for 10 days after mixing, after which any unused portion must be discarded. 1
Common Pitfalls to Avoid
Do not use once-daily dosing for skin infections—the FDA label explicitly requires twice-daily administration for this indication because once-daily regimens have not been studied. 1
Do not exceed the maximum daily dose of 600 mg, regardless of weight-based calculations. 1
Diarrhea is the most common adverse effect (reported in 12.5% of pediatric patients in some studies); counsel families accordingly and ensure adequate hydration. 4, 6
Cefdinir is not first-line therapy for community-acquired pneumonia—amoxicillin at 90 mg/kg/day remains the preferred agent for fully immunized children, with cefdinir reserved as an alternative for β-lactam allergy or β-lactamase-producing organisms. 3, 7