Cefdinir vs. Cefuroxime

• Cefdinir and cefuroxime (Zinacef, Ceftin) are cephalosporin antibiotics used to treat a range of infections.
• The brand name for cefdinir called Omnicef is discontinued in the U.S.
• Side effects of cefdinir and cefuroxime that are similar include diarrhea or loose stools, nausea, vomiting, abdominal pain, headache, vaginitis, and skin rash.
• Side effects of cefdinir that are different from cefuroxime include vaginal yeast infection, and rarely, abnormal liver tests.
• Rare side effects of cefdinir include abnormal stool, constipation, and dry mouth.
• Side effects of cefuroxime that are different from cefdinir include hives, mouth ulcers. Serious side effects of cefuroxime include allergic reactions, severe skin reactions, anemia, and seizures.
• Both cefdinir and cefuroxime can cause a potentially serious condition called pseudomembranous colitis (Clostridium difficile colitis), a severe bacterial infection of the colon.
• People allergic to the penicillin class of antibiotics may also be allergic to cefdinir or cefuroxime. Serious and rare allergic reactions may include anaphylaxis, seizures, and low red blood cell or platelet counts.

Cefdinir and cefuroxime (Zinacef, Ceftin) are cephalosporin antibiotics used to treat infections cause by susceptible bacteria such as infections of the tonsils (tonsillitis), throat (strep throat), larynx (laryngitis), middle ear (otitis media), sinuses (sinusitis), lungs (pneumonia), bronchi (bronchitis), and skin and other soft tissues. Other cephalosporin antibiotics include cephalexin (Keflex), cefaclor (Ceclor), cefixime (Suprax), cefpodoxime (Vantin), and cefprozil (Cefzil).

Cefdinir

• Cefdinir generally is well tolerated. The most common side effects are:
  • Diarrhea or loose stools
  • Nausea
  • Abdominal pain
  • Vaginal moniliasis
  • Vaginitis
  • Vomiting
  • Rash
  • Headache
• Rare side effects include:
  • Abnormal liver tests
  • Allergic reactions
  • Abnormal stool
  • Constipation
  • Dry mouth
• 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 (Clostridium difficile colitis), a potentially serious bacterial infection of the colon.

Patients who develop signs of pseudomembranous colitis after starting cefdinir (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.

• Persons who are allergic to the penicillin class of antibiotics, for example, amoxicillin, amoxicillin and clavulanic acid (Augmentin), which are related to cephalosporins, may or may not be allergic to cephalosporins.

Cefuroxime

Cefuroxime is generally well tolerated, and side effects are usually transient. Commonly reported side effects are:

• diarrhea,
• nausea,
• vomiting,
• abdominal pain,
• headache,
• rash,
• hives,
• vaginitis, and
• mouth ulcers.

Other important side effects include:

• Allergic reactions,
• severe skin reactions,
• anemia, and
• seizures.

Since cefuroxime is chemically related to penicillin, patients allergic to penicillin may develop an allergic reaction (sometimes even anaphylaxis) to cefuroxime. Cefuroxime like other antibiotics can alter the colon's normal bacteria, leading to overgrowth of a bacterium called Clostridium difficile. Overgrowth of this bacterium leads to the release of toxins that contribute to the development of Clostridium difficile-associated diarrhea, which may range in severity from mild diarrhea to fatal pseudomembranous colitis.

Cefdinir

• Cefdinir is taken once or twice daily, depending on the type and severity of the infection.
• The capsules or suspension can be taken with or without food.
• Patients with advanced kidney 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 type of infection.
• For most infections, once daily dosing is as effective as twice daily dosing, although once daily dosing has not been evaluated for the treatment of skin infections or pneumonia.

Cefuroxime

• Typical adult oral doses are 250 or 500 mg twice daily for 7-20 days depending on the type and severity of the infection.
• A single 1000 mg dose may used for uncomplicated gonorrhea.
• The tablets and suspension are not interchangeable.

Cefdinir

• Aluminum or magnesium containing antacids reduce the absorption of cefdinir from the intestine. Separating the administration of cefdinir and such antacids by two hours prevents this interaction.
• Iron supplements also reduce the absorption of cefdinir. Separating the administration of cefdinir and iron supplements by two hours prevents this interaction. There have been reports of reddish stool in patients who have received cefdinir. This could be due to the formation of a chemical complex between cefdinir and iron in the stomach.

Cefuroxime

• Probenecid increases the concentration of cefuroxime in the blood. Drugs that reduce acidity in the stomach (for example, antacids, H2-blockers, proton pump inhibitors) may reduce absorption of cefuroxime.

Cefdinir

• There are no adequate studies of cefdinir in pregnant women; however, studies in animals suggest no important effects on the fetus.
• Cefdinir is not secreted in human milk.

Cefuroxime

• Cephalosporins are usually considered safe for use during pregnancy.
• Cefuroxime is excreted in breast milk and may cause adverse effects in the infant. Cefuroxime is approved for pediatric patients 3 months and older.