cefdinir

cefdinir /cef·din·ir/ (sef´dĭ-nir) a third-generation cephalosporin effective against a wide range of bacteria.

---

cef·di·nir (sfd-nîr)

n.

A broad-spectrum cephalosporin antibiotic given orally to treat respiratory, ear, and skin infections.

---

cefdinir,

a broad-spectrum cephalosporin (third generation) antibiotic.

indications This drug is used to treat Haemophilus influenzae, H. parainfluenzae, Morganella catarrhalis, Streptococcus pneumoniae, Staphylococcus pyogenes, and S. aureus.

contraindications Known hypersensitivity to cephalosporins prohibits its use. It also should not be used in infants less than 1 month old.

adverse effects Life-threatening effects include proteinuria, nephrotoxicity, renal failure, leukopenia, thrombocytopenia, agranulocytosis, neutropenia, lymphocytosis, eosinophilia, pancytopenia, hemolytic anemia (rare), and anaphylaxis. Other serious adverse effects include bleeding, anemia, thrombophlebitis; and increased aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, lactic dehydrogenase, alkaline phosphatase, and blood urea nitrogen. Common side effects include nausea, vomiting, diarrhea, and anorexia.

---

cefdinir [sef´dĭ-nir]

a semisynthetic, third-generation cephalosporin effective against a wide range of bacteria, used in the treatment of otitis media, bronchitis, pharyngitis, tonsillitis, sinusitis, bacterial pneumonia, and skin and soft tissue infections; administered orally.

---

cefdinir

Omnicef

Pharmacologic class: Third-generation cephalosporin

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gram-negative and gram-positive bacteria, with expanded activity against gram-negative bacteria. Exhibits minimal immunosuppressant activity.

Availability

Capsules: 300 mg

Oral suspension: 125 mg/5 ml in 60- and 100-ml bottles

⊘Indications and dosages

➣ Acute bacterial otitis media caused by Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis

Adults and children ages 13 and older: 300 mg P.O. q 12 hours or 600 mg P.O. q 24 hours for 10 days

Children ages 6 months to 12 years: 7 mg/kg P.O. q 12 hours for 5 to 10 days or 14 mg/kg P.O. q 24 hours for 10 days

➣ Uncomplicated skin and soft-tissue infections caused by Staphylococcus aureus and Streptococcus pyogenes

Adults and children ages 13 and older: 300 mg P.O. q 12 hours for 10 days. Maximum dosage is 600 mg/day.

➣ Acute maxillary sinusitis caused by H. influenzae, S. pneumoniae, and M. catarrhalis

Adults and children ages 13 and older: 300 mg P.O. q 12 hours or 600 mg P.O. q 24 hours for 10 days. Maximum dosage is 600 mg/day.

Children ages 6 months to 12 years: 7 mg/kg P.O. q 12 hours or 14 mg/kg P.O. q 24 hours for 10 days

➣ Pharyngitis or tonsillitis caused by S. pyogenes, chronic bronchitis caused by H. influenzae, S. pneumoniae, and M. catarrhalis

Adults and children ages 13 and older: 300 mg P.O. q 12 hours for 5 to 10 days or 600 mg P.O. q 24 hours for 10 days. Maximum dosage is 600 mg/day.

➣ Community-acquired pneumonia caused by H. influenzae, Haemophilus parainfluenzae, S. pneumoniae, and M. catarrhalis

Adults and children ages 13 and older: 300 mg P.O. q 12 hours for 10 days. Maximum dosage is 600 mg/day.

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to cephalosporins or penicillins

Precautions

Use cautiously in:
• renal impairment, phenylketonuria
• history of GI disease (especially colitis)
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Obtain specimens for culture and sensitivity tests as necessary before starting therapy.
• Give with or without food.
• Administer 2 hours before or after iron supplements or antacids containing aluminum or magnesium.
• Give capsules, if possible, to diabetic patients (oral suspension contains 2.86 g of sucrose per teaspoon).

Route	Onset	Peak	Duration
P.O.	Rapid	2-4 hr	12-24 hr

Adverse reactions

CNS: headache, lethargy, paresthesia, syncope, seizures

CV: hypotension, palpitations, chest pain, vasodilation

EENT: hearing loss

GI: nausea, vomiting, diarrhea, abdominal cramps, oral candidiasis, pseudomembranous colitis

GU: vaginal candidiasis, nephrotoxicity

Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression

Hepatic: hepatomegaly, hepatic failure

Musculoskeletal: arthralgia

Respiratory: dyspnea

Skin: chills, fever, urticaria, maculopapular or erythematous rash

Other: superinfection, anaphylaxis, serum sickness

Interactions

Drug-drug. Aminoglycosides, loop diuretics: increased risk of nephrotoxicity

Antacids, iron-containing preparations: decreased cefdinir absorption

Probenecid: decreased excretion and increased blood level of cefdinir

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, gamma-glutamyltransferase, lactate dehydrogenase: increased levels

Coombs' test, urinary 17-ketosteroids, nonenzyme-based urine glucose tests (such as Clinitest): false-positive results

Hemoglobin, platelets, white blood cells: decreased values

Drug-herbs. Angelica, anise, arnica, asafetida, bogbean, boldo, celery, chamomile, clove, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, horse chestnut, horseradish, licorice, meadowsweet, onion, ginseng, papain, passionflower, poplar, prickly ash, quassia, red clover, turmeric, wild carrot, wild lettuce, willow: increased risk of bleeding

Patient monitoring

• Monitor CBC and kidney and liver function test results.
• Monitor for signs and symptoms of superinfection and other serious adverse reactions.

Patient teaching

• Tell patient he may take drug with or without food.
• Instruct patient to report persistent diarrhea (more than four episodes daily) and other adverse effects.
• If patient uses antacids or iron-containing preparations (such as iron supplements), tell him to take these 2 hours before or after cefdinir.
• Inform patient that drug may temporarily discolor stools.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.