(see INDICATIONS AND USAGE for Indicated Pathogens)
The recommended dosage and duration of treatment for infections in pediatric patients are described in the following chart; the total daily dose for all infections is 14 mg/kg, up to a maximum dose of 600 mg per day. Once-daily dosing for 10 days is as effective as BID dosing. Once-daily dosing has not been studied in skin infections; therefore, cefdinir for oral suspension should be administered twice daily in this infection. Cefdinir for oral suspension may be administered without regard to meals.
Pediatric Patients (Age 6 Months Through 12 Years)
Type of Infection
Dosage
Duration
Acute Bacterial Otitis Media
7 mg/kg q12h
or
14 mg/kg q24h
5 to 10 days
10 days
Acute Maxillary Sinusitis
7 mg/kg q12h
or
14 mg/kg q24h
10 days
10 days
Pharyngitis/Tonsillitis
7 mg/kg q12h
or
14 mg/kg q24h
5 to 10 days
10 days
Uncomplicated Skin and Skin Structure Infections
7 mg/kg q12h
10 days
CEFDINIR FOR ORAL SUSPENSION PEDIATRIC DOSAGE CHART
*
Pediatric patients who weigh ≥43 kg should receive the maximum daily dose of 600 mg.
Weight
125 mg/5 mL
250 mg/5 mL
9 kg/20 lbs
2.5 mL q12h or 5 mL q24h
Use 125 mg/5 mL product
18 kg/40 lbs
5 mL q12h or 10 mL q24h
2.5 mL q12h or 5 mL q24h
27 kg/60 lbs
7.5 mL q12h or 15 mL q24h
3.75 mL q12h or 7.5 mL q24h
36 kg/80 lbs
10 mL q12h or 20 mL q24h
5 mL q12h or 10 mL q24h
≥43 kg*/95 lbs
12 mL q12h or 24 mL q24h
6 mL q12h or 12 mL q24h
Patients With Renal Insufficiency
For adult patients with creatinine clearance <30 mL/min, the dose of cefdinir should be 300 mg given once daily.
Creatinine clearance is difficult to measure in outpatients. However, the following formula may be used to estimate creatinine clearance (CLcr) in adult patients. For estimates to be valid, serum creatinine levels should reflect steady-state levels of renal function.
Males: CLcr = (weight) (140 – age)
(72) (serum creatinine)
Females: CLcr = 0.85 x above value
where creatinine clearance is in mL/min, age is in years, weight is in kilograms, and serum creatinine is in mg/dL6.
The following formula may be used to estimate creatinine clearance in pediatric patients:
CLcr = K x body length or height
serum creatinine
where K = 0.55 for pediatric patients older than 1 year7 and 0.45 for infants (up to 1 year)8.
In the above equation, creatinine clearance is in mL/min/1.73 m2, body length or height is in centimeters, and serum creatinine is in mg/dL.
For pediatric patients with a creatinine clearance of <30 mL/min/1.73 m2, the dose of cefdinir should be 7 mg/kg (up to 300 mg) given once daily.
6
Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16:31-41.
7
Schwartz GJ, Haycock GB, Edelmann CM, Spitzer A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 1976; 58:259-63.
8
Schwartz GJ, Feld LG, Langford DJ. A simple estimate of glomerular filtration rate in full-term infants during the first year of life. J Pediatrics 1984; 104:849-54.
Patients on Hemodialysis
Hemodialysis removes cefdinir from the body. In patients maintained on chronic hemodialysis, the recommended initial dosage regimen is a 300 mg or 7 mg/kg dose every other day. At the conclusion of each hemodialysis session, 300 mg (or 7 mg/kg) should be given. Subsequent doses (300 mg or 7 mg/kg) are then administered every other day.
Directions for Mixing Cefdinir for Oral Suspension
Final Concentration
Final Volume
(mL)
Amount of Water
Directions
125 mg/5 mL
60
38 mL
Tap bottle to loosen powder, then add water in 2 portions. Shake well after each aliquot.
100
63 mL
250 mg/5 mL
60
38 mL
Tap bottle to loosen powder, then add water in 2 portions. Shake well after each aliquot.
100
63 mL
After mixing, the suspension can be stored at room temperature (25°C/77°F). The container should be kept tightly closed, and the suspension should be shaken well before each administration. The suspension may be used for 10 days, after which any unused portion must be discarded.
