Treatment of AOM caused by S. pneumoniae (penicillin-susceptible strains only), H. influenzae (including β-lactamase-producing strains), or M. catarrhalis (including β-lactamase-producing strains).
Not a drug of first choice; considered a preferred alternative to amoxicillin or amoxicillin and clavulanate in patients with a history of non-type 1 hypersensitivity reactions to penicillin.
Pharyngitis and Tonsillitis
Treatment of pharyngitis and tonsillitis caused by susceptible S. pyogenes (group A β-hemolytic streptococci). Generally effective in eradicating S. pyogenes from the nasopharynx, but efficacy in prevention of subsequent rheumatic fever has not been established to date.
CDC, AAP, IDSA, AHA, and others recommend oral penicillin V or IM penicillin G benzathine as treatments of choice; oral cephalosporins and oral macrolides considered alternatives. Amoxicillin sometimes used instead of penicillin V, especially for young children.
Respiratory Tract Infections
Treatment of acute maxillary sinusitis caused by susceptible Streptococcus pneumoniae (penicillin-susceptible strains only), Haemophilus influenzae (including β-lactamase-producing strains), or Moraxella catarrhalis (including β-lactamase-producing strains).
Treatment of mild to moderate acute exacerbations of chronic bronchitis caused by susceptible S. pneumoniae (penicillin-susceptible strains only) or β-lactamase- and non-β-lactamase-producing H. influenzae, H. parainfluenzae, or M. catarrhalis.
Treatment of mild to moderate community-acquired pneumonia (CAP) caused by susceptible S. pneumoniae (penicillin-susceptible strains only) or β-lactamase- and non-β-lactamase-producing strains of H. influenzae, H. parainfluenzae, or M. catarrhalis. If an oral cephalosporin is used as an alternative to penicillin G or amoxicillin for treatment of CAP caused by penicillin-susceptible S. pneumoniae, ATS and IDSA recommend cefpodoxime, cefprozil, cefuroxime, cefdinir, or cefditoren.
Skin and Skin Structure Infections
Treatment of uncomplicated skin and skin structure infections caused by S. aureus (including β-lactamase-producing strains) or S. pyogenes.
Dosage and Administration
Administration
Oral Administration
Administer orally.
Administration of cefdinir capsules or oral suspension with a high-fat meal decreases peak plasma concentration and AUC of cefdinir; manufacturer states this is not likely to be clinically important and the drug may be given without regard to meals.
For most infections, may be administered once daily or in 2 divided doses every 12 hours; once-daily regimen not recommended for treatment of CAP or skin and skin structure infections.
Reconstitution
Reconstitute oral suspension at time of dispensing by adding the amount of water specified on the container in 2 portions; invert bottle and shake after each addition.
Reconstituted suspension contains 125 or 250 mg of cefdinir/5 mL.
Shake suspension well prior to administration of each dose.
Dosage
Pediatric Patients
Acute Otitis Media (AOM)
Oral
Children 6 months to 12 years of age weighing <43 kg: 14 mg/kg once daily for 10 days or 7 mg/kg every 12 hours for 5–10 days.
Pharyngitis and Tonsillitis
Oral
Children 6 months to 12 years of age weighing <43 kg: 14 mg/kg once daily for 10 days or 7 mg/kg every 12 hours for 5–10 days.
Children ≥13 year of age or weighing ≥43 kg: 600 mg once daily for 10 days or 300 mg every 12 hours for 5–10 days.
Respiratory Tract Infections
Acute Sinusitis
Oral
Children 6 months through 12 years of age weighing <43 kg: 14 mg/kg once daily for 10 days or 7 mg/kg every 12 hours for 10 days.
Children ≥13 years of age or weighing ≥43 kg: 600 mg once daily for 10 days or 300 mg every 12 hours for 10 days.
Acute Exacerbations of Chronic Bronchitis
Oral
Children ≥13 year of age: 600 mg once daily for 10 days or 300 mg every 12 hours for 5–10 days.
Community-acquired Pneumonia
Oral
Children ≥13 year of age: 300 mg every 12 hours for 10 days.
Skin and Skin Structure Infections
Oral
Children 6 months to 12 years of age weighing <43 kg: 7 mg/kg every 12 hours for 10 days.
Children ≥13 year of age or weighing ≥43 kg: 300 mg every 12 hours for 10 days.
Adults
Pharyngitis and Tonsillitis
Oral
600 mg once daily for 10 days or 300 mg every 12 hours for 5–10 days.
Respiratory Tract Infections
Acute Sinusitis
Oral
600 mg once daily for 10 days or 300 mg every 12 hours for 10 days.
Acute Exacerbations of Chronic Bronchitis
Oral
600 mg once daily for 10 days or 300 mg every 12 hours for 5–10 days.
Community-acquired Pneumonia
Oral
300 mg every 12 hours for 10 days.
Skin and Skin Structure Infections
Oral
300 mg every 12 hours for 10 days.
Special Populations
Hepatic Impairment
No dosage adjustments required.
Renal Impairment
Dosage adjustments recommended in patients with severe renal impairment (Clcr <30 mL/minute).
Adults: 300 mg once daily if Clcr <30 mL/minute.
Children: 7 mg/kg (maximum 300 mg) once daily if Clcr <30 mL/minute.
Patients maintained on long-term hemodialysis: Recommended initial dosage is 300 mg every 48 hours in adults and 7 mg/kg (maximum 300 mg) every 48 hours in children. Administer a supplemental dose (300 mg in adults or 7 mg/kg in children) at the end of each dialysis period.
Geriatric Patients
No dosage adjustments except those related to renal impairment. (See Renal Impairment under Dosage and Administration.)
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