Pharmacodynamics and pharmacokinetics of cefdinir, an oral extended spectrum cephalosporin

Background. Oral second and third generation cephalosporins are undergoing continuing research and development in the arena of pediatric infectious di sease in an attempt to fill voids created by existing agents in the quest f or the "ideal" antimicrobial, This paper reviews the in vitro antimicrobial activity (pharmacodynamics) and pharmacokinetics of cefdinir, an extended spectrum oral cephalosporin, with an emphasis on those aspects relevant to the pediatric patient population Methods. A MEDLINE literature search was conducted for the years 1985 throu gh 2000, identifying all English language papers examining the in vitro ant imicrobial activity and human pharmacokinetics of cefdinir. Bibliographies of these papers were reviewed, as were relevant data on file with the manuf acturer. Data synthesis. Cefdinir exhibits broad range in vitro activity against Gra m-positive and Gram-negative aerobes, It exhibits superior activity against Gram-positive aerobes, compared with drugs like cefixime, ceftibuten, cefu roxime and cefpodoxime. In addition it is stable to hydrolysis by many of t he common betalactamases, The pharmacokinetic parameters of cefdinir in chi ldren are similar to those obtained in adults using similar milligram per m (2) doses (300, 600 mg in adults = 7, 14 mg/kg in children, respectively). Conclusions, The pharmacodynamic and pharmacokinetic characteristics of cef dinir as described in this paper, as well as the results of the clinical tr ials program, support the use of this agent in the treatment of a wide vari ety of pediatric infectious diseases.