Cefdinir

Class: Third Generation Cephalosporins
Molecular Formula: C₁₄H₁₃N₅O₅S₂
CAS Number: 91832-40-5
Brands: Omnicef

Introduction

Antibacterial; β-lactam antibiotic; aminothiazolyl derivative third generation cephalosporin.^{1 2 3 4 5 6}

Uses for Cefdinir

Acute Otitis Media (AOM)

Treatment of AOM caused by S. pneumoniae (penicillin-susceptible strains only), H. influenzae (including β-lactamase-producing strains), or M. catarrhalis (including β-lactamase-producing strains).^{1 12 37}

Not a drug of first choice; considered a preferred alternative to amoxicillin or amoxicillin and clavulanate in patients with a history of non-type 1 hypersensitivity reactions to penicillin.³⁷

Pharyngitis and Tonsillitis

Treatment of pharyngitis and tonsillitis caused by susceptible S. pyogenes (group A β-hemolytic streptococci).^{1 6 25} Generally effective in eradicating S. pyogenes from the nasopharynx, but efficacy in prevention of subsequent rheumatic fever has not been established to date.^{1 10 11 16 17 36}

CDC, AAP, IDSA, AHA, and others recommend oral penicillin V or IM penicillin G benzathine as treatments of choice;^{10 16 17 36} oral cephalosporins and oral macrolides considered alternatives.^{10 16 17 36} Amoxicillin sometimes used instead of penicillin V, especially for young children.^{10 16}

Respiratory Tract Infections

Treatment of acute maxillary sinusitis caused by susceptible Streptococcus pneumoniae (penicillin-susceptible strains only), Haemophilus influenzae (including β-lactamase-producing strains), or Moraxella catarrhalis (including β-lactamase-producing strains).^{1 7}

Treatment of mild to moderate acute exacerbations of chronic bronchitis caused by susceptible S. pneumoniae (penicillin-susceptible strains only) or β-lactamase- and non-β-lactamase-producing H. influenzae, H. parainfluenzae, or M. catarrhalis.^{1 15}

Treatment of mild to moderate community-acquired pneumonia (CAP) caused by susceptible S. pneumoniae (penicillin-susceptible strains only) or β-lactamase- and non-β-lactamase-producing strains of H. influenzae, H. parainfluenzae, or M. catarrhalis.^{1 4} If an oral cephalosporin is used as an alternative to penicillin G or amoxicillin for treatment of CAP caused by penicillin-susceptible S. pneumoniae, ATS and IDSA recommend cefpodoxime, cefprozil, cefuroxime, cefdinir, or cefditoren.³⁹

Skin and Skin Structure Infections

Treatment of uncomplicated skin and skin structure infections caused by S. aureus (including β-lactamase-producing strains) or S. pyogenes.^{1 5 24}

Cefdinir Dosage and Administration

Administration

Oral Administration

Administer orally.^{1 4 5 6 7 12 15 24}

Administration of cefdinir capsules or oral suspension with a high-fat meal decreases peak plasma concentration and AUC of cefdinir;^{1 28} manufacturer states this is not likely to be clinically important and the drug may be given without regard to meals.¹

For most infections, may be administered once daily or in 2 divided doses every 12 hours; once-daily regimen not recommended for treatment of CAP or skin and skin structure infections.¹

Reconstitution

Reconstitute oral suspension at time of dispensing by adding the amount of water specified on the container in 2 portions; invert bottle and shake after each addition.¹

Reconstituted suspension contains 125 or 250 mg of cefdinir/5 mL.¹

Shake suspension well prior to administration of each dose.¹

Dosage

Pediatric Patients

Acute Otitis Media (AOM)

Oral

Children 6 months to 12 years of age weighing <43 kg: 14 mg/kg once daily for 10 days¹ or 7 mg/kg every 12 hours for 5–10 days.¹

Pharyngitis and Tonsillitis

Oral

Children 6 months to 12 years of age weighing <43 kg: 14 mg/kg once daily for 10 days¹ or 7 mg/kg every 12 hours for 5–10 days.¹

Children ≥13 year of age or weighing ≥43 kg: 600 mg once daily for 10 days¹ or 300 mg every 12 hours for 5–10 days.¹

Respiratory Tract Infections

Acute Sinusitis

Oral

Children 6 months through 12 years of age weighing <43 kg: 14 mg/kg once daily for 10 days¹ or 7 mg/kg every 12 hours for 10 days.¹

Children ≥13 years of age or weighing ≥43 kg: 600 mg once daily for 10 days¹ or 300 mg every 12 hours for 10 days.¹

Acute Exacerbations of Chronic Bronchitis

Oral

Children ≥13 year of age: 600 mg once daily for 10 days¹ or 300 mg every 12 hours for 5–10 days.¹

Community-acquired Pneumonia

Oral

Children ≥13 year of age: 300 mg every 12 hours for 10 days.¹

Skin and Skin Structure Infections

Oral

Children 6 months to 12 years of age weighing <43 kg: 7 mg/kg every 12 hours for 10 days.¹

Children ≥13 year of age or weighing ≥43 kg: 300 mg every 12 hours for 10 days.¹

Adults

Pharyngitis and Tonsillitis

Oral

600 mg once daily for 10 days¹ or 300 mg every 12 hours for 5–10 days.¹

Respiratory Tract Infections

Acute Sinusitis

Oral

600 mg once daily for 10 days¹ or 300 mg every 12 hours for 10 days.¹

Acute Exacerbations of Chronic Bronchitis

Oral

600 mg once daily for 10 days¹ or 300 mg every 12 hours for 5–10 days.¹

Community-acquired Pneumonia

Oral

300 mg every 12 hours for 10 days.¹

Skin and Skin Structure Infections

Oral

300 mg every 12 hours for 10 days.¹

Special Populations

Hepatic Impairment

No dosage adjustments required.¹

Renal Impairment

Dosage adjustments recommended in patients with severe renal impairment (Cl_cr <30 mL/minute).¹

Adults: 300 mg once daily if Cl_cr <30 mL/minute.¹

Children: 7 mg/kg (maximum 300 mg) once daily if Cl_cr <30 mL/minute.¹

Patients maintained on long-term hemodialysis: Recommended initial dosage is 300 mg every 48 hours in adults and 7 mg/kg (maximum 300 mg) every 48 hours in children.¹ Administer a supplemental dose (300 mg in adults or 7 mg/kg in children) at the end of each dialysis period.¹

Geriatric Patients

No dosage adjustments except those related to renal impairment.¹ (See Renal Impairment under Dosage and Administration.)

Cautions for Cefdinir

Contraindications

• 
  

  Known hypersensitivity to cefdinir or other cephalosporins.¹

  
  

Warnings/Precautions

Warnings

Superinfection/Clostridium difficile-associated Diarrhea and Colitis (CDAD)

Possible emergence and overgrowth of nonsusceptible organisms with prolonged use.¹ Careful observation of the patient is essential.¹ Institute appropriate therapy if superinfection occurs.¹

Treatment with anti-infectives alters normal colon flora and may permit overgrowth of Clostridium difficile.¹ C. difficile-associated diarrhea and colitis (CDAD; also known as antibiotic-associated diarrhea and colitis or pseudomembranous colitis) has been reported with nearly all anti-infectives, including cefdinir, and may range in severity from mild diarrhea to fatal colitis.¹ Hyper toxin-producing strains of C. difficile are associated with increased morbidity and mortality since they may be refractory to anti-infectives and colectomy may be required.¹

Consider CDAD if diarrhea develops during or after therapy and manage accordingly.¹ Careful medical history is necessary since CDAD has been reported to occur as late as 2 months or longer after anti-infective therapy is discontinued.¹

If CDAD is suspected or confirmed, the anti-infective may need to be discontinued.¹ Some mild cases may respond to discontinuance alone.¹ Manage moderate to severe cases with fluid, electrolyte, and protein supplementation, anti-infective therapy active against C. difficile (e.g., oral metronidazole or vancomycin), and surgical evaluation when clinically indicated.¹

Sensitivity Reactions

Hypersensitivity Reactions

Possible hypersensitivity reactions such as urticaria, pruritus, rash (maculopapular, erythematous, morbilliform), fever and chills, eosinophilia, joint pain or inflammation, edema, erythema, genital and anal pruritus, angioedema, shock, hypotension, vasodilatation, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis, and anaphylaxis.¹

If an allergic reaction occurs, discontinue cefdinir and institute appropriate therapy as indicated (e.g., epinephrine, corticosteroids, and maintenance of an adequate airway and oxygen).¹

Cross-hypersensitivity

Partial cross-sensitivity among cephalosporins and other β-lactam antibiotics, including penicillins and cephamycins.^{1 10 20 21}

Prior to initiation of therapy, make careful inquiry concerning previous hypersensitivity reactions to cephalosporins, penicillins, or other drugs.¹ Cautious use recommended in individuals hypersensitive to penicillins:¹ avoid use in those who have had an immediate-type (anaphylactic) hypersensitivity reaction ^{10 21} and administer with caution in those who have had a delayed-type (e.g., rash, fever, eosinophilia) reaction.^a

General Precautions

Selection and Use of Anti-infectives

To reduce development of drug-resistant bacteria and maintain effectiveness of cefdinir and other antibacterials, use only for treatment or prevention of infections proven or strongly suspected to be caused by susceptible bacteria.¹

When selecting or modifying anti-infective therapy, use results of culture and in vitro susceptibility testing.¹ In the absence of such data, consider local epidemiology and susceptibility patterns when selecting anti-infectives for empiric therapy.¹

History of GI Disease

Use cephalosporins with caution in patients with a history of GI disease, particularly colitis.^{1 a} (See Superinfection/Clostridium-difficile-associated Diarrhea and Colitis under Cautions.)

Diabetes Mellitus

Reconstituted oral suspension contains 2.86 g of sucrose per 5 mL.¹

Specific Populations

Pregnancy

Category B.¹

Lactation

Not detected in milk.²⁶

Pediatric Use

Safety and efficacy not established in neonates and children <6 months of age.¹

Use for treatment of acute maxillary sinusitis in children 6 months to 12 years of age is supported by evidence from studies in adults and adolescents, the similar pathophysiology of acute sinusitis in adults and children, and data regarding the pharmacokinetics of cefdinir in children.¹

Adverse effects reported in pediatric patients similar to those in adults.¹ Increased incidence of diarrhea and rash in pediatric patients ≤2 years of age compared with older pediatric patients.¹

Geriatric Use

Well tolerated in geriatric patients; incidence of adverse effects (including diarrhea) lower than in those in younger adults.¹

Hepatic Impairment

Hepatic metabolism is negligible; dosage adjustments are not required.¹

Renal Impairment

Increased plasma half-life and decreased total body clearance.¹

Dosage adjustments necessary in those with severe renal impairment (Cl_cr <30 mL/minute).¹ (See Renal Impairment under Dosage and Administration.)

Careful clinical observation and renal function tests recommended prior to and during cephalosporin therapy.^a

Common Adverse Effects

GI effects (diarrhea, nausea) and rash.¹

Interactions for Cefdinir

Specific Drugs and Laboratory Tests

Drug or Test	Interaction	Comments
Antacids (aluminum- or magnesium-containing)	Decreased cefdinir absorption1	Administer cefdinir at least 2 hours before or after aluminum- or magnesium-containing antacids1
Iron supplements (multivitamin and mineral preparations containing iron)	Decreased cefdinir absorption1 8 Concomitant administration with iron-fortified infant formula (2.2 mg elemental iron/180 mL) has no effect on cefdinir pharmacokinetics1 Effect of iron-fortified food (e.g., iron-fortified breakfast cereal) has not been studied1 Possibility of reddish stools because of a nonabsorbable complex between cefdinir and iron in the GI tract	Administer cefdinir at least 2 hours before or after oral iron preparations1 8 Can be administered concomitantly with iron-fortified infant formula1
Nephrotoxic drugs	Potential for increased risk of nephrotoxicitya	Avoid concomitant use of nephrotoxic agents (e.g., aminoglycosides, colistin, polymyxin B, vancomycin) if possiblea
Probenecid	Decreased renal excretion of cefdinir and increased cefdinir serum concentrations and half-life1
Tests for glucose	Possible false-positive reactions in urine glucose tests using Clinitest, Benedict’s solution, or Fehling’s solution1	Use glucose tests based on enzymatic glucose oxidase reactions (e.g., Clinistix, Tes-Tape)1
Tests for ketones	Possible false-positive reactions in urine ketone tests using nitroprusside; no effect on nitroferricyanide tests1

Cefdinir Pharmacokinetics

Absorption

Bioavailability

16–25%.¹ Peak plasma concentrations attained 2–4 hours after an oral dose.^{1 23 27 28}

Bioavailability of oral suspension is 120% of that reported with capsules.¹

Food

Administration of cefdinir capsules or oral suspension with a high-fat meal decreases rate and extent of absorption;^{1 28} not considered clinically important.¹

Special Populations

Peak plasma concentrations and AUC may be higher in geriatric patients than in younger adults.¹

Distribution

Extent

Distributed into blister fluid, middle ear fluid, tonsils, sinus tissue, and bronchial mucosa and epithelial lining fluid in concentrations ranging from 15–48% of concurrent plasma concentrations.^{1 22 23}

Not known whether distributed into CSF.¹

Not detected in milk following a single 600-mg oral dose.¹

Plasma Protein Binding

60–70% in adult and pediatric patients;¹ binding is independent of concentration.^{1 23}

Elimination

Metabolism

Not appreciably metabolized.¹

Elimination Route

Eliminated principally by renal excretion;¹ approximately 12–18% eliminated unchanged in urine.¹

Half-life

Plasma elimination half-life 1.7–1.8 hours in adults with normal renal function.^{1 27}

Special Populations

Pharmacokinetics not studied to date in hepatic impairment.¹

Clearance decreased in renal impairment.¹ Plasma elimination half-life 2 times higher in patients with Cl_cr 30–60 mL/minute and 5 times higher in those with Cl_cr <30 mL/minute compared with normal renal function.¹

Stability

Storage

Oral

Capsules

25°C (may be exposed to 15–30°C).¹

For Suspension

25°C (may be exposed to 15–30°C).¹ Following reconstitution, store suspension in tight container at room temperature (25°C); discard after 10 days.¹

Actions and SpectrumActions

• 
  

  Third generation cephalosporin^{1 2 3 4 5 6} with an expanded spectrum of activity against aerobic gram-negative bacteria compared with first and second generation cephalosporins.^{1 2 3 4 5 6 7 9 13 14}

  
  


• 
  

  Usually bactericidal.¹

  
  


• 
  

  Like other β-lactam antibiotics, antibacterial activity results from inhibition of bacterial cell wall synthesis.^{1 a}

  
  


• 
  

  In vitro spectrum of activity includes many gram-positive aerobic bacteria and some gram-negative aerobic bacteria; inactive against anaerobic bacteria, fungi, and viruses.^{1 a}

  
  


• 
  

  Usually less active in vitro against susceptible staphylococci than first generation cephalosporins,^{1 a} however more active against susceptible staphylococci and streptococci than many other oral third generation cephalosporins (e.g., cefixime, cefpodoxime, ceftibuten).^{2 9 a}

  
  


• 
  

  Gram-positive aerobes: Active in vitro and in clinical infections against S. pneumoniae (penicillin-susceptible strains only), S. pyogenes (group A β-hemolytic streptococci), and Staphylococcus aureus.¹ Also active in vitro against S. agalactiae (group B streptococci), S. epidermidis (oxacillin-susceptible strains only), and viridans streptococci.¹ Enterococci (e.g., Enterococcus faecalis)^{1 3} and oxacillin-resistant (methicillin-resistant) staphylococci are resistant.^{1 3}

  
  


• 
  

  Gram-negative aerobes: Active in vitro and in clinical infections against non-β-lactamase-producing and β-lactamase-producing strains of H. influenzae, H. parainfluenzae, and M. catarrhalis.¹ Also active in vitro against Citrobacter diversus, Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis.¹ Inactive against most strains of Enterobacter and Pseudomonas aeruginosa.^{2 3}

  
  


• 
  

  Stable in the presence of a wide variety of β-lactamases produced by gram-negative and gram-positive bacteria; may be hydrolyzed by certain plasmid-mediated extended-spectrum β-lactamases.^{9 13 14 19}

  
  


• 
  

  Strains of staphylococci resistant to penicillinase-resistant penicillins (oxacillin-resistant [methicillin-resistant] staphylococci) should be considered resistant to cefdinir, although results of in vitro susceptibility tests may indicate that the organisms are susceptible to the drug.³⁸

  
  

Advice to Patients

• 
  

  Advise patients that antibacterials (including cefdinir) should only be used to treat bacterial infections and not used to treat viral infections (e.g., the common cold).¹

  
  


• 
  

  Importance of completing full course of therapy, even if feeling better after a few days.¹

  
  


• 
  

  Advise patients that skipping doses or not completing the full course of therapy may decrease effectiveness and increase the likelihood that bacteria will develop resistance and will not be treatable with cefdinir or other antibacterials in the future.¹

  
  


• 
  

  Advise patients that diarrhea is a common problem caused by anti-infectives and usually ends when the drug is discontinued.¹ Importance of contacting a clinician if watery and bloody stools (with or without stomach cramps and fever) occur during or as late as 2 months or longer after the last dose.¹

  
  


• 
  

  Importance of taking cefdinir at least 2 hours before or after antacids containing aluminum or magnesium or iron supplements (including multivitamins containing iron).¹

  
  


• 
  

  Importance of discontinuing cefdinir and informing clinician if an allergic reaction occurs.¹

  
  


• 
  

  For patients with diabetes, importance of being informed of sucrose content of oral suspension.¹

  
  


• 
  

  Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, or concomitant illness.¹

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.

  
  


• 
  

  Importance of informing patients of other important precautionary information. (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Cefdinir

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Capsules	300 mg*	Cefdinir Capsules
			Omnicef	Abbott
	For suspension	125 mg/5 mL*	Cefdinir for Suspension
			Omnicef	Abbott
		250 mg/5 mL*	Cefdinir for Suspension
			Omnicef	Abbott

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Cefdinir 125MG/5ML Suspension (TEVA PHARMACEUTICALS USA): 60/$47.99 or 120/$85.98

Omnicef 125MG/5ML Suspension (ABBOTT): 100/$95.43 or 300/$273.32

Omnicef 300MG Capsules (ABBOTT): 20/$119 or 60/$337.71

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions November 2008. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

1. Abbott Laboratories. Omnicef (cefdinir) capsules and for oral suspension prescribing information. North Chicago, IL; 2007 Jul.

2. Sultan T, Baltch AL, Smith RP et al. In vitro activity of cefdinir (FK482) and ten other antibiotics against gram-positive and gram-negative bacteria isolated from adult and pediatric patients. Chemotherapy. 1994; 40:80-91. [IDIS 325729] [PubMed 8131638]

3. Marchese A, Saverino D, Debbia EA et al. Antistaphylococcal activity of cefdinir, a new oral third-generation cephalosporin, alone and in combination with other antibiotics, at supra- and sub-MIC levels. J Antimicrob Chemother. 1995; 35:53-66. [IDIS 343749] [PubMed 7768782]

4. Drehobl M, Bianchi P, Keyserling CH et al. Comparison of cefdinir and cefaclor in treatment of community-acquired pneumonia. Antimicrob Agents Chemother. 1997; 41:1579-83. [IDIS 389493] [PubMed 9210689]

5. Tack KJ, Keyserling CH, McCarty J et al et al. Study of use of cefdinir versus cephalexin in treatment of skin infections in pediatric patients. Antimicrob Agents Chemother. 1997; 41:739-42. [IDIS 384384] [PubMed 9087480]

6. Tack KJ, Hedrick JA, Rothstein E et al. A study of 5-day cefdinir treatment for streptococcal pharyngitis in children. Arch Pediatr Adolesc Med. 1997; 151:45-9. [IDIS 379950] [PubMed 9006528]

7. Gwaltney JM Jr, Savolainen S, Rivas P et al et al. Comparative effectiveness and safety of cefdinir and amoxicillin-clavulanate in treatment of acute community-acquired bacterial sinusitis. Antimicrob Agents Chemother. 1997; 41:1517-20. [IDIS 389488] [PubMed 9210677]

8. Ueno K, Tanaka K, Tsujimura K et al. Impairment of cefdinir absorption by iron ion. Clin Pharmacol Ther. 1993; 54:473-5. [IDIS 323601] [PubMed 8222489]

9. Cohen MA, Joannides ET, Roland GE et al. In vitro evaluation of cefdinir (FK482), a new oral cephalosporin with enhanced antistaphylococcal activity and β-lactamase stability. Diagn Microbiol Infect Dis. 1994; 18:31-9. [PubMed 8026155]

10. American Academy of Pediatrics. 2006 Red Book: Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006:754.

11. Anon. Choice of antibacterial drugs. Med Lett Treat Guid. 2004; 2:18-26.

12. Adler M, McDonald PJ, Trostmann U et al. Cefdinir versus amoxicillin/clavulanic acid in the treatment of suppurative acute otitis media in children. Eur J Clin Microbiol Infect Dis. 1997; 16:214-9. [PubMed 9131324]

13. Payne DJ, Amyes SGB. Stability of cefdinir (CI-983, FK482) to extended-spectrum plasmid-mediated β-lactamases. J Med Microbiol. 1993; 38:114-7. [PubMed 8429536]

14. Labia R, Morand A. Interaction of cefdinir with beta-lactamases. Drugs Exp Clin Res. 1994; 20:43-8. [PubMed 7924895]

15. Sperling MJ, Puopolo A, Griffin TJ et al. Efficacy and safety of cefdinir in the treatment of patients with acute bronchitis. Clin Ther. 1996; 18:626-34. [IDIS 373579] [PubMed 8879891]

16. Bisno AL, Gerber MA, Gwaltney JM et al. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis. 2002; 35:113-25. [IDIS 484228] [PubMed 12087516]

17. Dajani A, Taubert K, Ferrieri et al. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Pediatrics. 1995; 96:758-64. [IDIS 355409] [PubMed 7567345]

18. Pichichero ME, Cohen R. Shortened course of antibiotic therapy for acute otitis media, sinusitis and tonsillopharyngitis. Pediatr Infect Dis J. 1997; 16:680-95. [IDIS 390075] [PubMed 9239773]

19. Moosdeen F. The evolution of resistance to cephalosporins. Clin Infect Dis. 1997; 24:487-93. [IDIS 382961] [PubMed 9114204]

20. Kishiyam JL, Adelman DC. The cross-reactivity and immunology of β-lactam antibiotics. Drug Safety. 1994; 10:318-27. [PubMed 8018304]

21. Thompson JW, Jacobs RF. Adverse effects of newer cephalosporins: an update. Drug Saf. 1993; 9:132-42. [PubMed 8397890]

22. Cook PJ, Andrews JM, Wise R et al. Distribution of cefdinir, a third generation cephalosporin antibiotic, in serum and pulmonary compartments. J Antimicrob Chemother. 1996; 37:331-9. [IDIS 364506] [PubMed 8707743]

23. Richer M, Allard S, Manseau L et al. Suction-induced blister fluid penetration of cefdinir in healthy volunteers following ascending oral doses. Antimicrob Agents Chemother. 1995; 39:1082-6. [IDIS 346312] [PubMed 7625793]

24. Tack KJ, Littlejohn TW, Mailloux G et al et al. Cefdinir versus cephalexin for the treatment of skin and skin-structure infections. Clin Ther. 1998; 20:244-56. [IDIS 405657] [PubMed 9589816]

25. Tack KJ, Henry DC, Gooch WM et al et al. Five-day cefdinir treatment for streptococcal pharyngitis. Antimicrob Agents Chemother. 1998; 42:1073-5. [IDIS 404900] [PubMed 9593129]

26. Parke-Davis, Morris Plains, NJ: Personal communication.

27. Guttendorf RJ, Misiak PM, Koup JR et al. Safety, tolerance, and pharmacokinetics of cefdinir (CI-983, FK-482) after single and multiple doses. In: American Society for Microbiology. Program and abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago, IL; 1991:415. Abstract No. 1535.

28. Misiak P, Guttendorf R, Vassos A et al. Effect of high-fat meal on pharmacokinetics of cefdinir (CI-983, FK 482). In: American Society for Microbiology. Program and abstracts of the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy. Anaheim, CA; 1992:271. Abstract No. 963.

29. Klein JO. Selection of oral antimicrobial agents for otitis media and pharyngitis. Infect Dis Clin Pract. 1995; 4(Suppl 2):S88-94.

30. Klein JO. Management of streptococcal pharyngitis. Pediatr Infect Dis J. 1994; 13:572-5. [IDIS 331902] [PubMed 8078757]

31. Pichichero ME. Cephalosporins are superior to penicillin for treatment of streptococcal tonsillopharyngitis: is the difference worth it? Pediatr Infect Dis. 1993; 12:268-74.

32. Dajani AS, Kessler SL, Mendelson R et al. Cefpodoxime proxetil vs. penicillin V in pediatric streptococcal pharyngitis/tonsillitis. Pediatr Infect Dis J. 1993; 12:275-9. [PubMed 8483620]

33. Aujard Y, Boucot I, Brahimi N et al. Comparative efficacy and safety of four-day cefuroxime axetil and ten-day penicillin treatment of group A beta-hemolytic streptococcal pharyngitis in children. Pediatr Infect Dis J. 1995; 14:295-300. [IDIS 345876] [PubMed 7603811]

34. Mehra S, Van Moerkerke M, Welck J et al. Short course therapy with cefuroxime axetil for group A streptococcal tonsillopharyngitis in children. Pediatr Infect Dis J. 1998; 17:452-7. [IDIS 408830] [PubMed 9655533]

35. Milatovic D. Evaluation of cefadroxil, penicillin and erythromycin in the treatment of streptococcal tonsillopharyngitis. Pediatr Infect Dis J. 1991; 10:S61-3. [PubMed 1945599]

36. Cooper RJ, Hoffman JR, Bartlett JG et al. Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann Intern Med. 2001; 134:509-17. [IDIS 460578] [PubMed 11255530]

37. American Academy of Pediatrics and American Academy of Family Physicians Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics. 2004: 113:1451-65.

38. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; sixteenth informational supplement. CLSI document M100-S16. Wayne, PA; 2006.

39. Mandell LA, Wunderink RG, Anzueto A et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007; 44 Suppl 2:S27-72. [PubMed 17278083]

a. AHFS Drug Information 2003. McEvoy GK, ed. Cephalosporins General Statement. Bethesda, MD: American Society of Health-System Pharmacists; 2003:125-39.

More Cefdinir resources

• Cefdinir Side Effects (in more detail)
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• Cefdinir Prescribing Information (FDA)


• Cefdinir MedFacts Consumer Leaflet (Wolters Kluwer)


• Cefdinir Professional Patient Advice (Wolters Kluwer)


• cefdinir Advanced Consumer (Micromedex) - Includes Dosage Information


• Omnicef Prescribing Information (FDA)


• Omnicef Consumer Overview

Compare Cefdinir with other medications

• Bronchitis
• Otitis Media
• Pneumonia
• Sinusitis
• Skin and Structure Infection
• Skin Infection
• Strep Throat
• Tonsillitis/Pharyngitis