Description

Simple

An antibiotic used to treat certain bacterial infections.

Clinical

A third generation cephalosporin used to treat susceptible Gram negative and Gram positive bacterial infections.

Overview

Cefdinir, also known as Omnicef, is a semi-synthetic, broad-spectrum antibiotic belonging to the third generation of the cephalosporin class. It has been proven to be effective for the treatment of common bacterial infections in the ear, sinus, throat, lungs, and skin. Cefdinir was approved by the FDA in 1997 to treat a variety of mild to moderate infections and was initially marketed by Abbvie.[6] Because of its chemical structure, it is effective against organisms that are resistant to first-line cephalosporin therapy due to the production of beta-lactamase enzymes.[2,3]

Pharmacology

Indication

Cefdinir is indicated to treat acute bacterial otitis media, acute maxillary sinusitis, community-acquired (CA) pneumonia, acute bacterial exacerbations of chronic bronchitis, pharyngitis/tonsillitis, and uncomplicated skin and skin structure infections in children and adults.[ Read more

Pharmacodynamic

Cefdinir is a bactericidal agent that treats bacterial infections by interfering with cell wall synthesis.[14]
Cefdinir exerts broad-spectrum activity against a variety of gram-positive and g... Read more

Mechanism of action

Five-member thiazolidine rings that make up penicillins are replaced in cephalosporins by a six-member dihydrothiazine ring, conferring greater bactericidal activity. This This 6-member ring enables cefdinir and other cephalosporins to resist inactivation by certain bacterial enzymes.[ Read more

Absorption

Maximal plasma cefdinir concentration can be attained between 2-4 hours after an ingested dose.[14] The bioavailability of cefdinir depends on the formulation used. The estimated bioavailabil... Read more

Protein binding

The plasma protein binding of cefdinir ranges from 60% to approximately 70%.[ Read more

Volume of distribution

The average volume of distribution of cefdinir in adults is about 0.35 L/kg and 0.67 L/kg in children.[14,18... Read more

Clearance

The renal clearance in healthy adults in a pharmacokinetic study was 2.0 (± 1.0) mL/min/kg and the clearance in patients with renal failure was lower, decreasing in proportion to the degree of renal impairment.[18 Read more

Half life

The average plasma elimination half-life is about 1.7 hours in adults.[14] In children and healthy infants, plasma elimination half-life ranges from 1.2–1.5 hours.[ Read more

Route of elimination

This drug is mainly excreted by the kidneys. Dose adjustments may be required for patients with renal impairment or patients on dialysis.[14] Approximately 18.4% of a 300 mg dose of cefdinir w... Read more

Toxicity

LD50 information
Oral LD50 of cefdinir in the rat is >2000 mg/kg.[15]

There are limited data regarding cefdinir overdose in the literature. In studies of rodents, one 5600-mg/kg dose administered orally did not le... Read more

Adverse Effects

Contraindications

  • Regions: US
  • Patient Conditions:
      • Name: Known hypersensitivity to cephalosporins
      • Drugbank Id: DBCOND0121227

Food Interactions

  • Avoid multivalent ions. Do not take aluminum, magnesium, or iron containing products up to 2 hours before or after this medication.
  • Take with or without food. The absorption is unaffected by food.

Interactions

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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(R)-warfarin
The risk or severity of bleeding can be increased when Cefdinir is combined with (R)-warfarin.
(S)-Warfarin
The risk or severity of bleeding can be increased when Cefdinir is combined with (S)-Warfarin.
4-hydroxycoumarin
The risk or severity of bleeding can be increased when Cefdinir is combined with 4-hydroxycoumarin.
Abacavir
Cefdinir may decrease the excretion rate of Abacavir which could result in a higher serum level.
Abciximab
The therapeutic efficacy of Abciximab can be decreased when used in combination with Cefdinir.
Acarbose
Acarbose may decrease the excretion rate of Cefdinir which could result in a higher serum level.
Aceclofenac
Aceclofenac may decrease the excretion rate of Cefdinir which could result in a higher serum level.
Acemetacin
Acemetacin may decrease the excretion rate of Cefdinir which could result in a higher serum level.
Acenocoumarol
The risk or severity of bleeding can be increased when Cefdinir is combined with Acenocoumarol.
Acetaminophen
Acetaminophen may decrease the excretion rate of Cefdinir which could result in a higher serum level.
Acetazolamide
Acetazolamide may increase the excretion rate of Cefdinir which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acid
The excretion of Cefdinir can be decreased when combined with Acetylsalicylic acid.
Aclidinium
Cefdinir may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Acrivastine
Cefdinir may decrease the excretion rate of Acrivastine which could result in a higher serum level.
Acyclovir
The excretion of Cefdinir can be decreased when combined with Acyclovir.
Adefovir
Adefovir may decrease the excretion rate of Cefdinir which could result in a higher serum level.
Adefovir dipivoxil
Adefovir dipivoxil may decrease the excretion rate of Cefdinir which could result in a higher serum level.
Albutrepenonacog alfa
Cefdinir may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level.
Alclofenac
Alclofenac may decrease the excretion rate of Cefdinir which could result in a higher serum level.
Aldesleukin
Aldesleukin may decrease the excretion rate of Cefdinir which could result in a higher serum level.
18 References
  1. 1 . Kimura Y, Kawamura M, Owada M, Fujiwara T, Maesawa C, Hiramori K: Successful steroid therapy for cefdinir-induced acute tubulointerstitial nephritis with progressive renal failure. Intern Med. 2001 Feb;40(2):114-7. doi: 10.2169/internalmedicine.40.114.PubMed: 11300142
  2. 2 . Perry CM, Scott LJ: Cefdinir: a review of its use in the management of mild-to-moderate bacterial infections. Drugs. 2004;64(13):1433-64. doi: 10.2165/00003495-200464130-00004.PubMed: 15212560
  3. 3 . Guay DR: Pharmacodynamics and pharmacokinetics of cefdinir, an oral extended spectrum cephalosporin. Pediatr Infect Dis J. 2000 Dec;19(12 Suppl):S141-6.PubMed: 11144395
  4. 4 . Paris MM, Devcich KJ: Overview of cefdinir: pharmacokinetics, safety, and efficacy in the treatment of uncomplicated skin and skin structure infections. Cutis. 2004 May;73(5 Suppl):14-8.PubMed: 15182160
  5. 5 . Chen J, Ahmad J: Cefdinir-induced hepatotoxicity: potential hazards of inappropriate antibiotic use. J Gen Intern Med. 2008 Nov;23(11):1914-6. doi: 10.1007/s11606-008-0758-y. Epub 2008 Aug 28.PubMed: 18752027
  6. 6 . Sader HS, Biedenbach DJ, Streit JM, Jones RN: Cefdinir activity against contemporary North American isolates from community-acquired urinary tract infections. Int J Antimicrob Agents. 2005 Jan;25(1):89-92. doi: 10.1016/j.ijantimicag.2004.07.006.PubMed: 15620832
  7. 7 . Ochiai S, Sekiguchi S, Hayashi A, Shimadzu M, Ishiko H, Matsushima-Nishiwaki R, Kozawa O, Yasuda M, Deguchi T: Decreased affinity of mosaic-structure recombinant penicillin-binding protein 2 for oral cephalosporins in Neisseria gonorrhoeae. J Antimicrob Chemother. 2007 Jul;60(1):54-60. Epub 2007 May 31.PubMed: 17540669
  8. 8 . Ferrer-Gonzalez E, Kaul M, Parhi AK, LaVoie EJ, Pilch DS: beta-Lactam Antibiotics with a High Affinity for PBP2 Act Synergistically with the FtsZ-Targeting Agent TXA707 against Methicillin-Resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2017 Aug 24;61(9). pii: AAC.00863-17. doi: 10.1128/AAC.00863-17. Print 2017 Sep.PubMed: 28630190
  9. 9 . Sanbongi Y, Suzuki T, Osaki Y, Senju N, Ida T, Ubukata K: Molecular evolution of beta-lactam-resistant Haemophilus influenzae: 9-year surveillance of penicillin-binding protein 3 mutations in isolates from Japan. Antimicrob Agents Chemother. 2006 Jul;50(7):2487-92.PubMed: 16801430
  10. 10 . Kumar P, Chauhan V, Silva JRA, Lameira J, d'Andrea FB, Li SG, Ginell SL, Freundlich JS, Alves CN, Bailey S, Cohen KA, Lamichhane G: Mycobacterium abscessus l,d-Transpeptidases Are Susceptible to Inactivation by Carbapenems and Cephalosporins but Not Penicillins. Antimicrob Agents Chemother. 2017 Sep 22;61(10). pii: AAC.00866-17. doi: 10.1128/AAC.00866-17. Print 2017 Oct.PubMed: 28760902
  11. 11 . Moore BA, Jevons S, Brammer KW: Peptidoglycan transpeptidase inhibition in Pseudomonas aeruginosa and Escherichia coli by Penicillins and Cephalosporins. Antimicrob Agents Chemother. 1979 Apr;15(4):513-7. doi: 10.1128/aac.15.4.513.PubMed: 111613
  12. 12 . Prober CG: Cephalosporins: an update. Pediatr Rev. 1998 Apr;19(4):118-27. doi: 10.1542/pir.19-4-118.PubMed: 9557062
  13. 13 . Labro MT, el Benna J, Charlier N, Abdelghaffar H, Hakim J: Cefdinir (CI-983), a new oral amino-2-thiazolyl cephalosporin, inhibits human neutrophil myeloperoxidase in the extracellular medium but not the phagolysosome. J Immunol. 1994 Mar 1;152(5):2447-55.PubMed: 8133056
  14. 14 . FDA Approved Drug Products: Omnicef (cefdinir) Link
  15. 15 . Pfizer MSDS, Cefdinir Link
  16. 16 . Omnicef Link
  17. 17 . Appropriate prescribing of beta-lactamase antibiotics Link
  18. 18 . Dailymed: Cefdinir capsule Link