Cefdinir

Mechanism :

As with other cephalosporins, bactericidal activity of cefdinir results from inhibition of cell wall synthesis. 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.

Indication :

• Acute bacterial otitis media
• Pharyngitis/Tonsillitis
• Uncomplicated Skin and Skin Structure Infections

Contraindications :

Cefdinir is contraindicated in patients with known allergy to the cephalosporin class of antibiotics.

Dosing :

Adverse Effect :

Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme, erythema nodosum, serum sickness, conjunctivitis, stomatitis, acute hepatitis, cholestasis, fulminant hepatitis, hepatic failure, jaundice, increased amylase, shock, anaphylaxis, facial and laryngeal edema, acute enterocolitis, bloody diarrhea, haemorrhagic colitis, melena, pseudomembranous colitis, pancytopenia, granulocytopenia, leukopenia, thrombocytopenia, idiopathic thrombocytopenic purpura, hemolytic anemia, acute respiratory failure, asthmatic attack, drug-induced pneumonia, eosinophilic pneumonia, idiopathic interstitial pneumonia, fever, acute renal failure, nephropathy, bleeding tendency, coagulation disorder, disseminated intravascular coagulation, upper GI bleed, peptic ulcer, ileus, loss of consciousness, allergic vasculitis, possible cefdinir-diclofenac interaction, cardiac failure, chest pain, myocardial infarction, hypertension, involuntary movements, and rhabdomyolysis.

Interaction :

Antacids (aluminium- or magnesium-containing): Concomitant administration reduces the rate (Cmax) and extent (AUC) of absorption by approximately 40%. Time to reach Cmax is also prolonged by 1 hour. There are no significant effects on cefdinir pharmacokinetics if the antacid is administered 2 hours before or 2 hours after cefdinir.
Probenecid: As with other b-lactam antibiotics, probenecid inhibits the renal excretion of cefdinir.
Iron Supplements and Foods Fortified with Iron: Concomitant administration of cefdinir with a therapeutic iron supplement containing 60 mg of elemental iron (as FeSO4) or vitamins supplemented with 10 mg of elemental iron reduced extent of absorption by 80% and 31%, respectively.
There have been rare reports of reddish stools in patients who have received cefdinir in Japan. The reddish color is due to the formation of a nonabsorbable complex between cefdinir or its breakdown products and iron in the gastrointestinal tract.
Drug/Laboratory Test Interactions: A false-positive reaction for ketones in the urine may occur with tests using nitroprusside, but not with those using nitroferricyanide. The administration of cefdinir may result in a false-positive reaction for glucose in urine using Benedict's solution, or Fehling's solution. It is recommended that glucose tests based on enzymatic glucose oxidase reactions be used. Cephalosporins are known to occasionally induce a positive direct Coombs' test.

Hepatic Dose :