Pharmacy and Medical Editor: Jay W. Marks, MD

GENERIC NAME: cefdinir

BRAND NAME: Omnicef

DRUG CLASS AND MECHANISM: Cefdinir is a semi-synthetic (partially man-made) oral antibiotic in the cephalosporin family of antibiotics. The cephalosporin family includes cephalexin (Keflex), cefaclor (Ceclor), cefuroxime (Zinacef), cefpodoxime (Vantin), cefixime (Suprax), cefprozil and many injectable antibiotics. Like other cephalosporins cefdinir stops bacteria from multiplying by preventing bacteria from forming walls that surround them. The walls are necessary to protect bacteria from their environment and to keep the contents of the bacterial cell together. Bacteria cannot survive without a cell wall. Cefdinir is active against a very wide spectrum of bacteria, including Staphylococcus aureus; Streptococcus pneumoniae; Streptococcus pyogenes (the cause of strep throat); Hemophilus influenzae; Moraxella catarrhalis; E. coli ; Klebsiella; and Proteus mirabilis. It is not active against Pseudomonas. Therapeutic uses of cefdinir include otitis media (infections of the middle ear), infections of soft tissues, and respiratory tract infections. It was approved by the FDA in December of 1997.

GENERIC AVAILABLE: Yes

PRESCRIPTION: Yes

PREPARATIONS: Capsules: 300 mg; oral suspension, 125 and 250 mg/5 mL

STORAGE: Capsules should be stored at room temperature, between 15-30 °C (59-86 °F).

PRESCRIBED FOR: Cefdinir is effective against susceptible bacteria causing infections of the middle ear (otitis media), tonsils (tonsillitis ), throat, larynx (laryngitis), bronchi (bronchitis), lungs (pneumonia), and skin and other soft tissues.

DOSING: Cefdinir is taken once or twice daily, depending on the nature and severity of the infection. The capsules or suspension can be taken with or without food. Patients with advanced renal disease may need to take lower doses to prevent accumulation of cefdinir since it is eliminated from the body by the kidneys.

For adult infections the usual dose is 300 mg every 12 hours or 600 mg per day for 5-10 days depending on the nature and severity of the infection. The recommended dose for children 6 months to 12 years of age is 7 mg/kg every 12 hours or 14 mg/kg per day for 5-10 days depending on the infection. For most infections once daily dosing is as effective as twice daily dosing, though once daily dosing has not been evaluated for the treatment of skin infections or pneumonia.

DRUG INTERACTIONS: Aluminum or magnesium containing antacids reduce the absorption of cefdinir from the intestine. Separating the administration of cefdinir and such antacids by 2 hours prevents this interaction.

Iron supplements also reduce the absorption of cefdinir. Separating the administration of cefdinir and such antacids by 2 hours prevents this interaction.

PREGNANCY: There are no adequate studies of cefdinir in pregnant women ; however, studies in animals suggest no important effects on the fetus.

NURSING MOTHERS: It is not known if cefdinir is secreted in breast milk.

SIDE EFFECTS: Cefdinir generally is well tolerated. The most common side effects are diarrhea or loose stools, nausea, abdominal pain, vomiting , rash and headache. Rarer side effects include abnormal liver tests and allergic reactions. Cefdinir may cause false test results with some tests for sugar in the urine. Like most antibiotics cefdinir may cause a condition called pseudomembranous colitis, a bacterial infection of the colon.