Cefdinir: An expanded-spectrum oral cephalosporin

OBJECTIVE: To review the antimicrobial activity, pharmacokinetics, clinical efficacy, and tolerability of cefdinir, an expanded-spectrum oral cephalos porin. DATA SOURCES: Literature was identified by a MEDLINE search (January 1983-N ovember 1999) of the medical literature, review of English-language literat ure and bibliographies of these articles, and product information. STUDY SELECTION: Clinical efficacy data were selected from all published tr ials mentioning cefdinir. Additional information concerning in vitro suscep tibility, safety, chemistry, and pharmacokinetic profile of cefdinir was al so reviewed. DATA SYNTHESIS: Cefdinir, an oral expanded-spectrum cephalosporin, has a br oad spectrum of activity against many gram-negative and -positive aerobic o rganisms, including Streptococcus pneumoniae, Staphylococcus aureus, Stepto coccus pyogenes, Haemophilus influenzae, and Moraxella catarrahalis. Cefdin ir is stable to hydrolysis by many common beta -lactamases. Cefdinir is rap idly absorbed from the gastrointestinal tract and is primarily eliminated v ia renal clearance of unchanged drug. The terminal disposition half-life of cefdinir is approximately 1.5 hours. Efficacy has been demonstrated in a n umber of clinical trials in adults and children with upper and lower respir atory tract infections (e.g., pharyngitis, sinusitis, acute otitis media, a cute bronchitis, acute exacerbation of chronic bronchitis, community-acquir e pneumonia) and skin and skin-structure infections. The adverse event prof ile is similar to that of comparator agents. CONCLUSIONS: Cefdinir is a second-line alternative to first-line antimicrob ial agents, with convenient once- or twice-daily dosing in the treatment of upper and lower respiratory tract infections and skin and skin-structure i nfections. Similar to other oral expanded-spectrum cephalosporins, cefdinir has activity against common pathogens of the respiratory tract and skin an d is stable in the presence of many beta -lactamases. The clinical choice o f an oral expanded-spectrum cephalosporin will be based on patient acceptan ce, frequency of administration, and cost.