Third-Generation Cephalosporin
Staphylococcus aureus (methicillin susceptible), Coagulase negative Staphylococci, Streptococcus pneumoniae (penicillin susceptible), Streptococcus spp., Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitides, Neisseria gonorrhoeae, Enterobacteriaceae, E. coli
Cephalosporins exert bactericidal activity by interfering with bacterial cell wall synthesis and inhibiting cross-linking of the peptidoglycan. The cephalosporins are also thought to play a role in the activation of bacterical cell autolysins which may contribute to bacterial cell lysis.
Cephalosporins exhibit time-dependent killing (T > MIC)
Dose of 600mg: Cmax: 2.4 mcg/L; Tmax: 3.2 hour; Half-life: 1.5 hours; Table 10
Hypersensitivity: Maculopapular rash, Urticaria, Pruritis, Anaphylaxis/angioedema, eosinophilia
Hematologic: Hypoprothrombinemia, Neutropenia, Leukopenia, Thrombocytopenia
GI: Diarrhea, C. difficile disease
Renal: Interstitial nephritis
PO: 300mg capsule
Powder for Reconstitution: 125mg/5mL, 250mg/5mL
Acute exacerbation of chronic bronchitis: 300mg PO q12h x 5-10 days OR 600mg PO q24h x 10 days
Community acquired pneumonia: 300mg PO q12h x 10 days
Acute maxillary sinusitis: 300mg PO q12h OR 600mg PO q24h x 10 days
Pharyngitis: 300 mg PO q12h x 5-10 days OR 600mg PO q24h x 10 days
7-14mg/kg/day divided q12-24h
Renal failure: adults: CrCl < 30mL/min, 300mg q24h
children: CrCl < 30mL/min/1.73 m2, 7 mg/kg q24h (up to 300 mg/day)
Hepatic failure: No dosing changes recommended at this time.
Precautions: hypersensitivity to penicillins, history of gastrointestinal disease, particularly colitis, renal impairment, bleeding disorders (like other cephalosporins, cefdinir may be capable of producing hypoprothrombinemia)
Antacids: decreased cefdinir efficacy
Live Typhoid Vaccine: decreased immunological response to the typhoid vaccine
Iron: decreased cefdinir efficacy
Probenecid: increased cefdinir bioavailability
Category B: No evidence of risk in humans but studies inadequate.
Therapeutic: Culture and sensitivities, serum levels, signs and symptoms of infection, white blood cell count
Toxic: Urinalysis, BUN, SCr, AST and ALT, skin rash, Neutropenia and leukopenia, Prothrombin time in patients with renal or hepatic impairment or poor nutritional state, as well as patients receiving a protracted course of antimicrobial therapy, and patients previously stabilized on anticoagulant therapy.
Omnicef Ò/Abbott