Cefdinir

ORAL ADMINISTRATION. The nurse administers cephalosporins around the clock to the patient to provide adequate blood levels. Most cephalosporins may be taken with food to prevent gastric upset. Cefdinir may be taken without regard to food. The absorption of oral cefuroxime and cefpodoxime is increased when given with food. However, if the patient experiences gastrointestinal upset, the nurse can administer the drug with... 

Uncomplicated exacerbation Not requiring hospitalization Less than 3 exacerbations per year No comorbid illness I I V, greater than 50% predicted No recent antibiotic therapy Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis Oral Macrolide (azithromycin, clarithromycin) Second- or third-generation cephalosporin (cefuroxime, cefpodoxime, cefdinir, cefprozil) Doxycycline Ketolide (telithromycin) P-Lactam/P-Iactamase inhibitor (amoxicillin-clavulanate) Intravenous Not recommended... 

Cefdinir 14 mg/kg per day in 1-2 doses (adult 300 mg twice daily or 600 mg once daily) Diarrhea, rash, vomiting, diaper rash, yeast infections Preferred oral cephalosporin (good taste) separate from Al or Mg antacids and Fe supplements by 2 hours... 

Cefdinir Cefpodoxime proxetil Cefuroxime axetil 600 mg/day in 1-2 doses 200 mg twice daily 250-500 mg twice daily 14 mg/kg per day in 1-2 doses 1 0 mg/kg per day in 2 doses 1 5-30 mg/kg per day in 2 doses Preferred oral liquid cephalosporin owing to palatability... 

Cefdinir 300 mg twice daily or 600 mg once daily 14 mg/kg per day in 1-2 doses 5-10 days Broad spectrum expensive... 

Second-generation cephalosporins—IV cefuroxime po cefaclor, cefditoren, cefprozil, cefuroxime axetil, and loracarbef. Third-generation cephalosporins—po cefdinir, cefixime, cefetamet, cefpodoxime proxetil, and ceftibuten. 

If treatment failure occurs with amoxicillin, an agent should be chosen with activity against /1-lactamase-producing H. influenzae and M. catar-rhalis as well as drug-resistant S. pneumoniae (such as high-dose amoxicil-lin-clavulanate (recommended), or, cefuroxime, cefdinir, cefpodoxime, cefprozil, or intramuscular ceftriaxone). 

Cefdinir 14 mg/kg/day once or twice daily Cefuroxime 30 mg/kg/day divided twice daily... 

Cefdinir 600 mg daily or divided in two doses 14 mg/kg/day in one dose or divided in two doses... 

In cephalosporins, the C(6) position corresponds to C(5) in penicillins or penicilloic acids. During the degradation of cephalosporins, epimerization at C(6) is generally not observed. However, there are exceptions to this rule. An investigation of the degradation kinetics of cefdinir (5.39a, Fig. 5.11) and its C(7)-epimer (5.39b) in aqueous solution showed that, after /3-lactam ring... 

The y-lactone degradation products of cefdinir were found to be also subject to C(6)-epimerization in neutral to basic solutions. The mechanism proposed for this epimerization involves deprotonation of the enamine N-atom,... 

Fig. 5.11. Family tree of the degradation products of cefdinir (5.39a) and its 7-epimer (5.39b) [112]...

Y. Okamoto, K. Kiriyama, Y. Namiki, J. Matsushita, M. Fujioka, T. Yasuda, Degradation Kinetics and Isomerization of Cefdinir, a New Oral Cephalosporin, in Aqueous Solution. 2. Hydrolytic Degradation Pathway and Mechanism for beta-Lactam Ring Opened Lactones , J. Pharm. Sci. 1996, 85, 984-989. 

Perry CM, Scott LJ. Cefdinir. A review of its use in the management of mild-to-moderate bacterial infections. Drugs 2004 64 1433-64. 

Third generation Examples are cefotaxime, cefoperazone, ceftazidime, ceftizoxime, ceftriaxone, cefdinir etc. This generation has greater Gramnegative activity but loses some Gram-positive potency. 

Cefdinir Dosage in Pediatric Patients (6 Months Through 12... 

Cefdinir for Oral Suspension Pediatric Dosage Chart Weight kg lb... 

Renal function impairment- For adult patients with Cor less than 30 mL/min, the dose of cefdinir should be 300 mg given once daily. 

Hemodialysis - Hemodialysis removes cefdinir from the body. In patients maintained on chronic hemodialysis, the recommended initial dosage regimen is a 300 mg or 7 mg/kg dose every other day. At the conclusion of each hemodialysis session, give 300 mg (or 7 mg/kg). Subsequent doses (300 mg or 7 mg/kg) are then administered every other day. 

Safety and efficacy in children younger than 1 month (cefazolin and cefaclor capsule and suspension), younger than 3 months (cefuroxime, and cefoxitin), younger than 5 months (cefpodoxime), younger than 6 months (cefdinir, loracarbef, ceftozoxime, and cefprozil), and younger than 1 year of age... 

Cefdinir may cause a false-positive reaction for ketones in urine when measured using nitroprusside but not nitroferricynide. 

CEPHALOSPORINS, THIRD GENERATION Cefdinir (Omnicef) Cefpodoxime (Vantin)... 

Cephalosporins Have a nucleus that is similar to that of (3-lactams and similarly dismpt the synthesis of the peptidoglycan layer. This layer is important in maintaining cell wall integrity in gram-positive bacteria. Omnicef (Cefdinir) Cefzil (Cefprozil) Cephalexin (Keflex) Bioavailabihty is dose dependent is only about 16-21%. About 90% is excreted as the parent compound. It is well absorbed by the body and 90% of the dmg is excreted unchanged. 

Space doses evenly around the clock and continue taking cefdinir for the full length of treatment... 

---