Trade Names:Spectracef- Tablets 200 mg
Inhibits mucopeptide synthesis in bacterial cell wall.
C max is about 1.8 mcg/mL. T max is 1 to 3 h. Cefditoren dipivoxil is about 14% bioavailable.
FoodAdministration following a high-fat meal increased AUC 70% and C max 50%.
Vd is about 9.3 L (at steady state). About 88% protein bound, primarily to albumin.
Hydrolyzed to cefditoren by esterases.
The t ½ is about 1.6 h. Eliminated by excretion into the urine. Renal Cl is about 4 to 5 L/h.
Unbound C max is 90% higher, AUC is 232% higher, and t ½ is 2.7 h.
Severe impairment (Ccr less than 30 mL/min/1.73 m 2 )Unbound C max is 114% higher, AUC is 324% higher, and t ½ is 4.7 h. Dosage adjustment is recommended.
ElderlyC max is increased 26% and AUC 33%, t ½ is 16% to 26% longer, and renal Cl is 20% to 24% lower. No dosage adjustment is needed.
Treatment of mild to moderate infections of acute bacterial exacerbation of chronic bronchitis, pharyngitis/tonsillitis, and uncomplicated skin and skin-structure infections caused by susceptible strains of specific microorganisms.
Hypersensitivity to cephalosporins or milk protein; carnitine deficiency or inborn errors of metabolism that result in clinically important carnitine deficiency.
PO 400 mg twice daily for 10 days.
Pharyngitis/Tonsillitis and Uncomplicated Skin and Skin Structure InfectionsAdults and Children (12 yr of age and older)PO 200 mg twice daily for 10 days.
Renal Function ImpairmentAdults and Children (12 yr of age and older) Mild renal impairment (Ccr 50 to 80 mL/min/1.73 m 2 )PO No dosage adjustment is necessary.
Moderate renal impairment (Ccr 30 to 49 mL/min/1.73 m 2 )PO less than 200 mg twice daily.
Severe renal impairment (Ccr less than 30 mL/min/1.73 m 2 )PO 200 mg daily.
End-stage renal diseasePO Dose not determined.
Administer each dose with food to increase absorption.
Store tablets at controlled room temperature (59° to 86°F). Protect from light and moisture.
May decrease cefditoren plasma levels, possibly reducing the efficacy.
ProbenecidMay increase plasma levels and the duration of activity of cefditoren.
May cause false-positive direct Coombs test; may cause false-positive urine glucose test results with Benedict or Fehling solution or Clinitest tablets but not with enzyme-based tests (eg, Clinistix , Tes-Tape ); may cause false-negative test in the ferricyanide test for blood glucose but not the glucose oxidase or hexokinase methods of determination.
Headache; reversible hyperactivity; seizures.
Stevens-Johnson syndrome; erythema multiforme; toxic epidermal necrolysis.
Diarrhea; nausea; abdominal pain; dyspepsia; vomiting; pseudomembranous colitis; colitis.
Vaginal moniliasis; hematuria; increased urine WBC; renal dysfunction; toxic nephropathy.
Decreased hematocrit; aplastic anemia; hemolytic anemia; hemorrhage; pancytopenia; neutropenia; agranulocytosis.
Hepatic dysfunction (eg, cholestasis).
Increased glucose.
Allergic reactions; anaphylaxis; drug fever; hypertonia; superinfection; serum sickness-like reaction.
Category B .
Undetermined.
Safety and efficacy not determined in children under 12 yr of age.
Because elderly patients are more likely to have decreased renal function, select dose with caution.
Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity.
Dosage adjustment is necessary.
Drug may cause bacterial or fungal overgrowth of nonsusceptible microorganisms.
Consider pseudomembranous colitis as a possibility in patients who develop diarrhea.
Nausea, vomiting, epigastric distress, diarrhea, convulsions.
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