What is the recommended cefdinir dosage for an 11‑kg child older than 6 months with normal renal function?

Cefdinir Dosing for an 11 kg Child

For an 11 kg child older than 6 months with normal renal function, administer cefdinir 7 mg/kg twice daily (77 mg twice daily) or 14 mg/kg once daily (154 mg once daily), depending on the infection severity and type. 1

Standard Pediatric Dosing Algorithm

The FDA-approved dosing for cefdinir in pediatric patients provides two regimens based on infection severity: 1

• 7 mg/kg/day divided twice daily (approximately 77 mg per dose for an 11 kg child) for mild-to-moderate infections 1, 2
• 14 mg/kg once daily (154 mg for an 11 kg child) as an alternative regimen that provides equivalent efficacy with improved compliance 1, 3

Practical Dosing Considerations

For an 11 kg child, the practical doses are:

• Twice-daily regimen: 75-80 mg every 12 hours 1
• Once-daily regimen: 150-155 mg every 24 hours 1

The oral suspension formulation allows for accurate weight-based dosing in pediatric patients, and cefdinir may be administered without regard to food, though high-fat meals reduce absorption by 33-44% in the suspension formulation. 1

Infection-Specific Guidance

Cefdinir demonstrates excellent efficacy against common community-acquired respiratory pathogens including Haemophilus influenzae, Moraxella catarrhalis, and penicillin-susceptible Streptococcus pneumoniae, with stability against beta-lactamase-producing strains. 2, 3

• Acute otitis media, pharyngitis, uncomplicated skin infections: Either 7 mg/kg twice daily or 14 mg/kg once daily for 5-10 days 2, 3
• Community-acquired pneumonia or more severe infections: Consider the twice-daily regimen for more consistent drug levels 2

Pharmacokinetic Rationale

Cefdinir achieves adequate tissue penetration in middle ear fluid (15% of plasma concentrations), tonsil tissue (24% of plasma), and sinus tissue (16% of plasma), supporting its use in respiratory tract infections. 1 The elimination half-life of approximately 1.7-2.2 hours in pediatric patients supports both once- and twice-daily dosing strategies. 4

Common Pitfalls to Avoid

• Do not underdose: Always calculate the dose based on current weight, as underdosing may lead to treatment failure and resistance development 2
• Diarrhea is the most common adverse event (occurring more frequently than with some comparators), but discontinuation rates remain low 2
• Renal adjustment is not needed in children with normal renal function, but cefdinir clearance is reduced proportionally to creatinine clearance in renal impairment 1