Drug Detail:Omnicef (Cefdinir [ sef-dih-neer ])
Generic Name: cefdinir
Dosage Form: capsules, oral suspension
Drug Class: Third generation cephalosporins
(see INDICATIONS AND USAGE for Indicated Pathogens)
Capsules
The recommended dosage and duration of treatment for infections in adults and adolescents are described in the following chart; the total daily dose for all infections is 600 mg. Once-daily dosing for 10 days is as effective as BID dosing. Once-daily dosing has not been studied in pneumonia or skin infections; therefore, OMNICEF Capsules should be administered twice daily in these infections. OMNICEF Capsules may be taken without regard to meals.
| Type of Infection | Dosage | Duration |
| Community-Acquired Pneumonia | 300 mg q12h | 10 days |
| Acute Exacerbations of Chronic Bronchitis | 300 mg q12h or 600 mg q24h |
5 to 10 days 10 days |
| Acute Maxillary Sinusitis | 300 mg q12h or 600 mg q24h |
10 days 10 days |
| Pharyngitis/Tonsillitis | 300 mg q12h or 600 mg q24h |
5 to 10 days 10 days |
| Uncomplicated Skin and Skin Structure Infections | 300 mg q12h | 10 days |
Powder for Oral Suspension
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, OMNICEF for Oral Suspension should be administered twice daily in this infection. OMNICEF for Oral Suspension may be administered without regard to meals.
| 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 |
| Weight | 125 mg/5 mL | 250 mg/5 mL |
|
a Pediatric patients who weigh ≥ 43 kg should receive the maximum daily dose of 600 mg. |
||
| 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 kga/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 × above value |
where creatinine clearance is in mL/min, age is in years, weight is in kilograms, and serum creatinine is in mg/dL.(3)
The following formula may be used to estimate creatinine clearance in pediatric patients:
| CLcr = K × | body length or height | |
| serum creatinine |
where K = 0.55 for pediatric patients older than 1 year(4) and 0.45 for infants (up to 1 year)(5).
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.
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.
| Final Concentration | Final Volume(mL) | Amount of Water | Directions |
| 125 mg/5 mL |
60 100 |
38 mL 63 mL |
Tap bottle to loosen powder, then add water in 2 portions. Shake well after each aliquot. |
| 250 mg/5 mL |
60 100 |
38 mL 63 mL |
Tap bottle to loosen powder, then add water in 2 portions. Shake well after each aliquot. |
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.
