cefdinir


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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).

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.

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References in periodicals archive ?
The anti-biotics therapy becomes more effective when anaerobes are also covered using second-or third-generation cephalosporins ie: (cefuroxime, cefpo-doxime, cefdinir), fluoroquinolones eg (cipro-floxacin, levofloxacin, moxifloxacin), Sinusitis due to dental problems or those with foul-smelling discharge metronidazole is essential.
In the table included in this column, I show calculations of predicted outcomes from amoxicillin, amoxicillin /clavulanate, and cefdinir treatment based on the projected otopathogen mix and resistance frequencies of 2016.
coli was found resistant to commonly used oral antibiotics like cotrimoxazole, ampicillin, cephalexin, cefuroxime, cefixime, cepodoxime and cefdinir. Most isolates of Klebsiella, Pseudomonas and Proteus were highly sensitive to Piperacillin-Tazobactum, Imipenem, Aminoglycosides, Fluroquinolones and Nitrofurantoin.
Amoxicillin + Clavulanate Potassium 400 mg/ 57 mg per 5 ml Oral Suspension; Cefuroxime Axetil (Cefuroxime) 250 mg/ 5 ml Oral Suspension and Cefdinir 250 mg/ 5 ml Oral Suspension.
Cefdinir and Cefixime) are useful for more severe community-acquired respiratory tract infections, resistant infections, and nosocomial or hospital-acquired infections.
After normalization, antibiotics were converted to oral cefdinir (Omnicef8) and ampicillin with plans for chronic suppressive therapy.
Narasimhan, "Synthesis and antibacterial evaluation of Cu(II) and Zn(II) complexes of the [beta]-lactum antibiotic, cefdinir," Medicinal Chemistry Research, vol.
Gober, "Long-term effects on the nasopharyngeal flora of children following antimicrobial therapy of acute otitis media with cefdinir or amoxycillin-clavulanate," Journal of Medical Microbiology, vol.
to the International Lyme and Associated Diseases Society (ILADS) to connect with a local Lyme disease specialist; and after 3 months her regimen was changed to doxycycline, azithromycin, and cefdinir.
coli strain antibiotic discs such as Amikacin (AK), Norfloxacin (NF), Pefloxacin (PF), Ciprofloxacin (CI), Cefuroxime Sodium (CR), Ofloxacin (OF), Nalidixic Acid (NA), Gentamicin (GM), Cefotaxime (CX), Ceftazidime (CZ), Ceftriaxone (FR), Cefixime (FX), Cefdinir (CN), and Nitrofurantoin (AT) were used, wherein only Amikacin (AK) showed sensitivity with zone of 15 mm and resistance for other antibiotics Figure 10(a).
aeruginosa strains were validated following the Clinical Laboratory Standards Institute (CLSI).9 The following antimicrobial agents were tested: amikacin (30 ug), ampicillin (10 ug), cefalotin (30 ug), ceftriaxone (30 ug), ciprofloxacin (5 ug), cotrimoxazole (1.25/23.75 ug), gentamicin (10 ug), tetracycline (30 ug), carbinicillin (100 ug), imipenem (10 ug), nalidixic acid (30 ug), nitroforantoin (300 ug ), norfloxacine (10 ug), cefepim (30 ug), cefdinir (30) ceftizoxime (30 ug), cefotaxime (30 ug) cefotaxime/clavulanic acid (30/10 ug), ceftazidime (30 ug), and ceftazidime/clavulanic acid (30/10 ug).
But the children were also randomly assigned to receive a seven-day course of one of two antibiotics -- amoxicillin or cefdinir -- or just a placebo.