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 200mg: Cmax: 3.4 mcg/L; Tmax: 2.0 hour; Half-life: 1.1 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: 200mg tablets
Acute exacerbation of chronic bronchitis: 400 mg PO q12h x 10 days
Pharyngitis: 200mg PO q12h x 10 days
Community acquired pneumonia: 400 mg PO q12h x 14 days
Tonsillitis: 200mg PO q12h x 10 days
Not recommended
Renal failure: CrCl 30-49 mL/min: 200 mg q12h
CrCl < 30 mL/min: 200 mg q24h
Hepatic failure: No dosing changes recommended at this time.
Contraindications: Carnitine deficiency or inborn errors of metabolism that may result in significant carnitine deficiency, Milk protein hypersensitivity
Precautions: hypersensitivity to penicillins, history of gastrointestinal disease, particularly colitis, renal impairment
Antacids: decreased cefditoren effectiveness
Cimetidine: decrease cefditoren serum concentrations
Famotidine: decrease cefditoren serum concentrations
Live Typhoid Vaccine: decreased immunological response to the typhoid vaccine
Nizatidine: decrease cefditoren serum concentrations
Probenecid: increased cefditoren serum concentrations and bioavailabity
Ranitidine: decrease cefditoren serum concentrations
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.
SpectracefÒ/Purdue