Cefditoren is a semisynthetic, broad-spectrum, beta-lactamase-resistant, third-generation cephalosporin with antibacterial activity. Cefditoren binds to and inactivates penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. PBPs are enzymes involved in the terminal stages of assembling the bacterial cell wall and in reshaping the cell wall during growth and division. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis.
Cefditoren is a third-generation cephalosporin antibiotic for oral use. It has a broad spectrum of activity and has been used to treat bacterial infections of the skin and respiratory tract, including bronchitis, pneumonia, and tonsillitis. The following represents MIC susceptibility data for a few medically significant microorganisms.
Mechanism of Action of Cefditoren
Cefditoren, like other beta-lactam antibiotics (e.g., penicillins), is mainly bactericidal. It inhibits the third and final stage of bacterial cell wall synthesis by preferentially binding to specific penicillin-binding proteins (PBPs) that are located inside the bacterial cell wall. Penicillin-binding proteins are responsible for several steps in the synthesis of the cell wall and are found in quantities of several hundred to several thousand molecules per bacterial cell. Penicillin-binding proteins vary among different bacterial species. Thus, the intrinsic activity of cefditoren, as well as the other cephalosporins and penicillins against a particular organism, depends on its ability to gain access to and bind with the necessary PBP. Like all beta-lactam antibiotics, the ability of cefditoren to interfere with PBP-mediated cell wall synthesis ultimately leads to cell lysis. Lysis is mediated by bacterial cell wall autolytic enzymes (i.e., autolysins). The relationship between PBPs and autolysins is unclear, but it is possible that the beta-lactam antibiotic interferes with an autolysin inhibitor.
In general, the following organisms are considered clinically susceptible to cefditoren: Haemophilus influenzae (including beta-lactamase-producing strains), Haemophilus parainfluenzae (including beta-lactamase-producing strains), Moraxella catarrhalis (including beta-lactamase-producing strains), methicillin-sensitive Staphylococcus aureus (MSSA), penicillin-susceptible strains of Streptococcus pneumoniae, and Streptococcus pyogenes. Cefditoren is usually active against the following organisms in vitro, but the clinical significance of these data is unknown: Streptococcus agalactiae, Streptococcus Groups C and G, and Viridans streptococci (penicillin-susceptible and -intermediate strains).
Indications of Cefditoren
- Pneumonia
- Skin and Structure Infection
- Skin or Soft Tissue Infection
- Bronchitis
- Tonsillitis/Pharyngitis
- Bacterial Infections
- Community Acquired Pneumonia (CAP)
- Streptococcal Pharyngitis
- Streptococcal tonsillitis
- Uncomplicated skin and subcutaneous tissue bacterial infections
- For the treatment of mild to moderate infections in adults and adolescents (12 years of age or older) which are caused by susceptible strains of microorganisms in acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia, pharyngitis/tonsillitis, and uncomplicated skin and skin-structure infections.
Contra-Indications of Cefditoren
- Clostridium difficile infection
- Carnitine Deficiency
- A decrease in the Blood-Clotting Protein Prothrombin
- Moderate to Severe Kidney Impairment
- Antimicrobial resistance, viral infection. …
- Cephalosporin hypersensitivity, penicillin hypersensitivity. …
- Dialysis, renal failure, renal impairment. …
- Colitis, diarrhea, GI disease, inflammatory bowel disease, pseudomembranous colitis, ulcerative colitis.
Allergies
- Cephalosporins
- Beta-lactams
Dosages of Cefditoren
Strengths: 200 mg; 400 mg
For oral dosage form (tablets):
- Adults and children 12 years of age and older—400 milligrams (mg) twice a day for ten days.
- Children under 12 years of age—Use and dose must be determined by your doctor.
- For oral dosage form (tablets):
- Adults and children 12 years of age and older—200 mg twice a day for ten days.
- Children under 12 years of age—Dose must be determined by your doctor.
Bronchitis
- Acute bacterial exacerbation of chronic bronchitis: 400 mg orally twice a day for 10 days
Pneumonia
- Community-acquired: 400 mg orally twice a day for 14 days
Tonsillitis/Pharyngitis
- 200 mg orally twice a day for 10 days
Skin or Soft Tissue Infection
- Uncomplicated: 200 mg orally twice a day for 10 days
Pediatric Dose
Bronchitis
12 years or older
- Acute bacterial exacerbation of chronic bronchitis: 400 mg orally twice a day for 10 days
Pneumonia
12 years or older
- Community-acquired: 400 mg orally twice a day for 14 days
Tonsillitis/Pharyngitis
- 12 years or older: 200 mg orally twice a day for 10 days
Skin and Structure Infection
12 years or older
- Uncomplicated: 200 mg orally twice a day for 10 days
Side Effects of Cefditoren
The most common
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- leukopenia/leukemia
- hemolytic anemia
- serum sickness
- agranulocytosis
- pain, swelling, irritation where injected
- stomach upset
- sweating
- skin color change, mild diarrhea
- mild nausea
- loss of appetite
- vaginal discharge and itching
- swelling of feet or legs
- chest pain
- constipation
- cough
- diarrhea or loose stools
- difficulty with breathing
- dizziness
- heartburn
More common
- Abdominal or stomach pain, discomfort, or tenderness
- chills or fever
- difficulty with moving
- headache, severe and throbbing
- joint or back pain
- muscle aching or cramping
- muscle pains or stiffness
- chest pressure or squeezing pain in chest
- excessive sweating
- feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
- sudden tingling or coldness in an arm or leg
- sudden slow or difficult speech
- sudden drowsiness or need to sleep
- fast breathing
- sharp pain when taking a deep breath
- fast or slow heartbeat
- coughing up blood
- rust colored urine
- decreased amount of urine
Rare
- Anxiety
- change in vision
- seizures
- abnormal or fast heart rate
- weight loss
- chest pain or tightness
- confusion
- cough
- Agitation
- arm, back, or jaw pain
- blurred vision
- chest pain or discomfort
- convulsions
- extra heartbeats
- hallucinations
- headache
- irritability
- muscle pain or cramps
- pale or yellowed skin, dark colored urine, fever, confusion or weakness;
- jaundice (yellowing of the skin or eyes);
- sore throat, and headache with a severe blistering, peeling, and red skin rash;
- swelling, rapid weight gain, feeling short of breath (even with mild exertion); or
- increased thirst, loss of appetite, urinating less than usual or not at all.
Drug Interactions of Cefditoren
Cefditoren may interact with following drugs, supplements & change the efficacy of drugs
- methotrexate ;
- antiviral medicines such as adefovir, cidofovir or foscarnet ;
- cancer medicine such as carmustine, cisplatin, ifosfamide, streptozocin, or tretinoin ;
- a diuretic such as bumetanide, furosemide , indapamide hydrochlorothiazide , metolazone, spironolactone , torsemide, and others;
- a medication that reduces stomach acid, such as an antacid, or cimetidine , famotidine ,omeprazole , ranitidine and others;
- IV antibiotics such as amphotericin B, amikacin, bacitracin, capreomycin gentamicin, kanamycin, streptomycin, or vancomycin ;
- medicines used to prevent organ transplant rejection, such as sirolimus or tacrolimus
- medicines used to treat ulcerative colitis, such as or sulfasalazine ; or
- pain or arthritis medicines such as aspirin acetaminophen diclofenac , etodolac ,ibuprofen , indomethacin, naproxen, and others.
- aminoglycosides such as amikacin, gentamicin, and tobramycin
- birth control pills
This is not a complete list of cefditoren drug interactions. Ask your doctor or pharmacist for more information.
Pregnancy & Lactation of Cefditoren
FDA pregnancy risk category B
Cefditoren crosses the placenta. Animal data reveal no teratogenic effects; however, a slight decrease in fetal weight was observed. Studies of doses 1 to 7.5 times the maximum recommended human dose in rabbits revealed a high incidence of abortion and maternal death. There are, however, no adequate and well-controlled studies of cefditoren use in pregnant women. Because animal studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cefditoren has not been studied for use during labor and delivery. Treatment should be given only if clearly needed.
Lactation
Although no information is available on the use of cefditoren during breastfeeding, cephalosporins are generally not be expected to cause adverse effects in breastfed infants.
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