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Cefdinir
Cefdinir is a third-generation cephalosporin antibiotic widely prescribed for treating bacterial infections due to its broad-spectrum activity against both Gram-positive and Gram-negative pathogens. Known for its oral bioavailability and convenient dosing, cefdinir is a preferred choice for outpatient management of infections. This article references the British National Formulary (BNF), Lippincott Textbook of Pharmacology, and Lange Basic & Clinical Pharmacology to provide a detailed overview of cefdinir, including its mechanism of action, clinical uses, dosing guidelines, side effects, precautions, drug interactions, and generic names.
Cefdinir exerts its bactericidal effect by inhibiting bacterial cell wall synthesis. According to the Lippincott Textbook of Pharmacology, cefdinir binds to penicillin-binding proteins (PBPs) on the bacterial cell wall, disrupting peptidoglycan cross-linking. This weakens the cell wall, leading to osmotic instability and cell lysis.
The Lange Basic & Clinical Pharmacology emphasizes cefdinir’s stability against many beta-lactamases, enzymes produced by bacteria to inactivate earlier cephalosporins. However, it is less effective against Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA).
Cefdinir is indicated for:
- Respiratory Tract Infections:
- Community-acquired pneumonia.
- Acute bacterial sinusitis.
- Acute exacerbations of chronic bronchitis.
- Pharyngitis and tonsillitis.
- Skin and Soft Tissue Infections:
- Uncomplicated cellulitis and impetigo.
- Urinary Tract Infections (UTIs):
- Uncomplicated cystitis caused by susceptible Escherichia coli.
The BNF highlights its role as a first-line option for mild to moderate infections in patients with penicillin allergies (non-severe).
Dosing is tailored to infection type, patient age, and renal function:
Adults and Adolescents (>12 years):
- 300 mg twice daily or 600 mg once daily for 5–10 days, depending on severity.
Children (6 months–12 years):
- 14 mg/kg/day in one or two divided doses (max 600 mg/day).
Renal Impairment:
- Creatinine Clearance (CrCl) <30 mL/min: Reduce dose to 300 mg once daily.
Administration Tips:
- Take orally with or without food.
- Avoid concomitant intake with iron supplements or antacids (separate by 2 hours).
Cefdinir is generally well-tolerated, but potential side effects include:
- Common:
- Gastrointestinal disturbances (diarrhea, nausea, abdominal pain).
- Headache or dizziness.
- Vaginal candidiasis.
- Serious (Rare):
- Hypersensitivity reactions (rash, anaphylaxis, Stevens-Johnson syndrome).
- Clostridioides difficile-associated diarrhea (CDAD).
- Hematologic effects (transient neutropenia, eosinophilia).
- Contraindications: Hypersensitivity to cephalosporins or severe beta-lactam allergy (e.g., anaphylaxis to penicillins).
- Renal Impairment: Dose adjustment required for CrCl <30 mL/min.
- Iron Supplements/Antacids: Concurrent use reduces absorption; administer 2 hours apart.
- Pregnancy and Lactation: Generally safe but use only if benefits outweigh risks (limited data).
- Pediatric Use: Approved for children ≥6 months.
Key interactions per the BNF and Lange Basic & Clinical Pharmacology:
- Antacids (e.g., aluminum/magnesium hydroxide): Reduce cefdinir absorption (separate doses by 2 hours).
- Iron Supplements or Multivitamins with Iron: Form insoluble complexes, decreasing cefdinir efficacy.
- Probenecid: May increase cefdinir serum levels (monitor for toxicity).
- Oral Typhoid Vaccine: Cefdinir may reduce vaccine efficacy (avoid concurrent use).
- Generic: Cefdinir.
Brand Names: Omnicef®, Cefdinir Capsules/Oral Suspension
