Trade Names:Omnicef- Capsules 300 mg- Powder for oral suspension 125 mg per 5 mL after reconstitution
Inhibits mucopeptide synthesis in bacterial cell wall.
T max is 2 to 4 h. Bioavailability is 21% (capsules) and 25% (suspension). For the capsules, the C max is about 1.6 to 2.87 mcg/mL and the AUC is about 7.05 to 11.1 mcg•h/mL.
Vd is about 0.35 L/kg. 60% to 70% protein bound.
Not appreciably metabolized.
The t ½ is about 1.7 h. Renally eliminated with 11.6% to 18.4% excreted unchanged in the urine. Renal Cl is about 2 mL/min/kg. Oral Cl is about 11.6 to 15.5 mL/min/kg. Cefdinir is dialyzable.
Cl is reduced. Dosage adjustment is recommended in patients with Ccr less than 30 mL/min.Elderly
C max is increased 44% and AUC by 86%. No dosage adjustment is required.
Treatment of community-acquired pneumonia, acute exacerbations of chronic bronchitis, acute maxillary sinusitis, pharyngitis and tonsillitis, uncomplicated skin and skin structure infections, and otitis media (pediatric patients only) caused by susceptible strains of specific microorganisms.
Hypersensitivity to cephalosporins.
PO 300 mg every 12 h for 10 days.Acute Exacerbation of Chronic BronchitisAdults and Children 13 yr of age and older
PO 300 every 12 h for 5 to 10 days or 600 mg every 24 h for 10 days.Acute Maxillary SinusitisAdults and Children 13 yr of age and older
PO 300 mg every 12 h or 600 mg every 24 h for 10 days.Children 6 mo to 12 yr of age
PO 7 mg/kg every 12 h or 14 mg/kg every 24 h for 10 days.Pharyngitis/TonsillitisAdults and Children 13 yr of age and older
PO 300 mg every 12 h for 5 to 10 days or 600 mg every 24 h for 10 days.Children 6 mo to 12 yr of age
PO 7 mg/kg every 12 h for 5 to 10 days or 14 mg/kg every 24 h for 10 days.Uncomplicated Skin and Skin Structure InfectionsAdults and Children 13 yr of age and older
PO 300 mg every 12 h for 10 days.Children 6 mo to 12 yr of age
PO 7 mg/kg every 12 h for 10 days.Acute Bacterial Otitis MediaChildren 6 mo to 12 yr of age
PO 7 mg/kg every 12 h for 5 to 10 days or 14 mg/kg every 24 h for 10 days.Renal Impairment (Ccr less than 30 mL/min)Adults and Children older than 13 yr of age
PO 300 mg/day.Children 6 mo to 12 yr of age
PO 7 mg/kg/day (max, 300 mg/day).
Store capsules, dry powder for oral suspension, and reconstituted suspension at controlled room temperature (59° to 86°F). Discard any unused suspension after 10 days.
Coadministration reduced absorption of cefdinir (separate doses by 2 h).Iron supplements and vitamins with iron
Coadministration reduces absorption of cefdinir (separate doses by 2 h).Probenecid
Inhibition of renal excretion of cefdinir.
May cause false-positive urine ketone test results when using nitroprusside reagent, but not with nitroferricyanide-based tests; may cause false positive urine glucose test results with Benedict solution, Fehling solution, or Clinitest but not with enzyme-based tests (eg, Clinistix , Tes-Tape ); false-positive direct Coombs test result in certain patients (eg, those with azotemia); false elevations in urinary 17-ketosteroid values.
Cardiac failure, hypertension, MI (postmarketing).
Headache (2%); involuntary movements, loss of consciousness (postmarketing).
Rash (3%); erythema multiforme, erythema nodosum, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis (postmarketing).
Diarrhea (15%); nausea (3%); abdominal pain, vomiting (1%); acute enterocolitis, bloody diarrhea, hemorrhagic colitis, ileus, melena, peptic ulcer, pseudomembranous colitis, stomatitis, upper GI bleed (postmarketing).
Vaginal moniliasis (4%); vaginitis (1%); acute renal failure, nephropathy (postmarketing).
Granulocytopenia, hemolytic anemia, idiopathic thrombocytopenic purpura, leukopenia, pancytopenia, thrombocytopenia, (postmarketing).
Acute hepatitis, cholestasis, fulminant hepatitis, hepatic failure, jaundice, increased amylase (postmarketing).
Bleeding tendency, coagulation disorder, disseminated intravascular coagulation (postmarketing).
Allergic vasculitis, anaphylaxis, facial and laryngeal edema (postmarketing).
Increased urine leukocytes and urine protein (2%); increased gamma-glutamyltransferase, decreased lymphocytes, microhematuria (1%).
Asthma attack, drug-induced pneumonia, eosinophilic pneumonia, idiopathic interstitial pneumonia, respiratory failure (postmarketing).
Chest pain, feeling of suffocation, fever, shock (postmarketing).
MonitorResponse to therapy
Monitor patient's response to therapy. Notify health care provider if infection does not appear to improve or worsens.Sensitivity
Review results of culture and sensitivity testing as appropriate. Ensure cefdinir is discontinued and another antimicrobial agent is started if sensitivity tests indicate that the organism is resistant to cefdinir.Side effects
Monitor patient for GI, DERM, and general body side effects, and signs of superinfection. Inform health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.
Category B .
Not detected in breast milk.
Safety and efficacy in children younger than 6 mo of age not established.
Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible crossreactivity.
Use drug with caution in patients with renal impairment. Dosage adjustment is recommended in patients with Ccr less than 30 mL/min.
May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Consider possibility in patients in whom diarrhea develops.
A single dose of 300 mg or 7 mg/kg (max, 300 mg) may be administered at the end of each dialysis session. Subsequent doses are then administered every other day.
Seizures, nausea, vomiting, epigastric distress, diarrhea.
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