Cefdinir is a semi-synthetic cephalosporin and a beta-lactam antibiotic with bactericidal activity. Cefdinir’s effect is dependent on its binding to penicillin-binding proteins (PBPs) located in the bacterial cytoplasmic membrane. Binding results in the inhibition of the transpeptidase enzymes, thereby preventing cross-linking of the pentaglycine bridge with the fourth residue of the pentapeptide and interrupting consequent synthesis of peptidoglycan chains. As a result, cefdinir inhibits bacterial septum and cell wall synthesis formation.
Cefdinir is a semi-synthetic, broad-spectrum antibiotic in the third generation of the cephalosporin class, proven effective for common bacterial infections of the ear, sinus, throat, and skin.
Mechanism of Action of Cefdinir
As with other cephalosporins, bactericidal activity of cefdinir results from inhibition of cell wall synthesis by acting on penicillin binding proteins (PBPs). Cefdinir is a third generation cephalosporin with a broad spectrum of activity against enteric gram-negative rods. Cefdinir is stable in the presence of some, but not all, b-lactamase enzymes. As a result, many organisms resistant to penicillins and some cephalosporins are susceptible to cefdinir. Cephalosporins work the same way as penicillins: they interfere with the peptidoglycan synthesis of the bacterial wall by inhibiting the final transpeptidation needed for the cross-links. This effect is bactericidal.
Indications of Cefdinir
- Sinusitis
- Pneumonia
- Bronchitis
- Otitis Media
- Skin and Structure Infection
- Skin or Soft Tissue Infection
- Strep Throat
- Tonsillitis/Pharyngitis
- Tonsils (tonsillitis)
- Throat (strep throat)
- Larynx (laryngitis)
- Sinuses (sinusitis)
- Bronchi (bronchitis)
- Lungs (pneumonia)
- Skin and other soft tissues
- Acute Exacerbation of Chronic Bronchitis caused by Haemophilus Influenza
- Acute Exacerbation of Chronic Bronchitis caused by Streptococcus Pneumoniae
- Acute Exacerbation of Chronic Bronchitis caused by haemophilus parainfluenza
- Acute exacerbation of chronic bronchitis caused by Moraxella catarrhalis
- Acute maxillary sinusitis caused by H. influenzae
- Acute maxillary sinusitis caused by M. catarrhalis
- Acute maxillary sinusitis caused by penicillin susceptable S.pneumoniae
- Pneumonia due to Haemophilus influenzae (H. influenzae)
- Skin infection caused by S. pyogenes
- Skin infection caused by Staphylococcus aureus
- Streptococcal Pharyngitis
- Streptococcal tonsillitis
- Acute otitis media caused by M. catarrhalis
- Acute otitis media caused by S.pneumoniae
- Bacterial otitis media caused by Haemophilus influenzae
- Community aquired pneumonia caused by H. parainfluenzae
- Community aquired pneumonia caused by M.catarrhalis
- Community aquired pneumonia caused by penicillin susceptable S. pneumoniae
- For the treatment of the respiratory, skin, soft tissue, and ENT infections caused by H. influenzae(including b-lactamase producing strains), H. parainfluenzae (including b-lactamase producing strains), S. pneumoniae (penicillin-susceptible strains), S. pyogenes, S. aureus (including b-lactamase producing strains), and M. catarrhalis.
Contra Indications of Cefdinir
- Clostridium difficile infection
- Severe Renal 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 to Cephalosporins , Betalactams
Dosages of Cefdinir
Strengths: 300 mg; 125 mg/5 mL; 250 mg/5 mL
For infections
- Adults and teenagers—300 milligrams (mg) every twelve hours or 600 mg once a day, taken for 5 to 10 days.
- Infants and children 6 months up to 12 years of age—Dose is based on body weight and must be determined by your doctor. The dose is usually 7 milligrams (mg) per kilogram (kg) of body weight every twelve hours or 14 milligrams (mg) per kilogram (kg) of body weight per day, taken for 5 to 10 days. However, the dose is usually not more than 600 mg per day.
- Infants up to 6 months of age—Use and dose must be determined by your doctor.
Pneumonia
- Community-acquired- 300 mg orally every 12 hours for 10 to 14 days
Bronchitis
- Acute exacerbations of chronic bronchitis – 300 mg orally every 12 hours for 5 to 10 days or 600 mg orally every 24 hours for 10 days
Sinusitis
- Acute maxillary sinusitis: 300 mg orally every 12 hours or 600 mg orally every 24 hours for 10 days
Skin or Soft Tissue Infection
- Uncomplicated: 300 mg orally every 12 hours for 10 days
Tonsillitis/Pharyngitis
- 300 mg orally every 12 hours for 5 to 10 days or 600 mg orally every 24 hours for 10 days
Pediatric Dose
Pneumonia
Community-acquired
- 13 years or older: 300 mg orally every 12 hours for 10 to 14 days
Bronchitis
Acute exacerbations of chronic bronchitis
- 13 years or older: 300 mg orally every 12 hours for 5 to 10 days or 600 mg orally every 24 hours for 10 days
Otitis Media
Acute bacterial otitis media
- 6 months through 12 years: 7 mg/kg orally every 12 hours for 5 to 10 days or 14 mg/kg orally every 24 hours for 10 days
- Maximum dose: 600 mg/day
Tonsillitis/Pharyngitis
- 6 months through 12 years: 7 mg/kg orally every 12 hours for 5 to 10 days or 14 mg/kg orally every 24 hours for 10 days
- Maximum dose: 600 mg/day
Sinusitis
Acute maxillary sinusitis
- 6 months through 12 years: 7 mg/kg orally every 12 hours or 14 mg/kg orally every 24 hours for 10 days
- Maximum dose: 600 mg/day
- 13 years or older: 300 mg orally every 12 hours or 600 mg orally every 24 hours for 10 days
Skin and Structure Infection
Uncomplicated
- 6 months through 12 years: 7 mg/kg orally every 12 hours for 10 days
- Maximum dose: 600 mg/day
- 13 years or older: 300 mg orally every 12 hours for 10 days
Side Effects of Cefdinir
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 Cefdinir
Cefdinir 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
- Iron supplements or iron-fortified foods
- Polysaccharide-Iron Complex
- Sodium Bicarbonate
- Sodium Ferric Gluconate Complex;
- ferric pyrophosphate citrate
(Cefdinir can usually be taken 2 hours before or 2 hours after iron-containing products or antacids.
Pregnancy & Lactation of Cefdinir
FDA Pregnancy Category B
Pregnancy
Cefdinir was not teratogenic in rats at oral doses up to 1000 mg/kg/day (70 times the human dose based on mg/kg/day, 11 times based on mg/m²/day) or in rabbits at oral doses up to 10 mg/kg/day (0.7 times the human dose based on mg/kg/day, 0.23 times based on mg/m²/day). Maternal toxicity (decreased body weight gain) was observed in rabbits at the maximum tolerated dose of 10 mg/kg/day without adverse effects on offspring. Decreased body weight occurred in rat fetuses at ≥ 100 mg/kg/day, and in rat offspring at ≥ 32 mg/kg/day.
Lactation
Although no information is available on the use of cefdinir during breastfeeding, cephalosporins are generally not be expected to cause adverse effects in breastfed infants.
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