cefdinir

Cefdinir (Omnicef) is a cephalosporin (third gen) works as bactericidal and inhibits synthesis of bacterial cell wall, causing cell death.

Generic Names & Brand Names

cefdinir

(sef’ din er)

Omnicef

Pregnancy Category B

Drug classes

Antibiotic

Cephalosporin (third generation)

Therapeutic actions

Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death.

Indications
ADULTS AND ADOLESCENTS
  • Community-acquired pneumonia caused by Haemophilus influenzae, H. parainfluenzae, Streptococcus pneumoniae, Mor­ax­ella catar­rhalis
  • Acute exacerbations of chronic bronchitis caused by H. influenzae, H. parainfluenzae, S. pneumoniae, M. catarrhalis
  • Acute maxillary sinusitis caused by H. influenzae, S. pneumoniae, M. catarrhalis
  • Pharyngitis and tonsillitis caused by S. pyogenes
  • Uncomplicated skin and skin structure infections caused by Staphylococcus aureus, S. pyogenes
PEDIATRIC PATIENTS
  • Acute bacterial otitis media caused by H. influenzae, S. pneumoniae, M. catarrhalis
  • Pharyngitis and tonsillitis caused by S. pyogenes
  • Uncomplicated skin and skin-structure infections caused by Staphylococcus aureus, S. pyogenes
Contraindications and cautions
  • Contraindicated with allergy to cephalosporins or penicillins.
  • Use cautiously with renal failure, lactation, pregnancy.
Available forms

Capsules—300 mg; oral suspension—125 mg/5 mL

Dosages
ADULTS AND ADOLESCENTS
  • Community-acquired infection, uncomplicated skin, or skin-structure infections: 300 mg PO q 12 hr for 10 days.
  • Acute exacerbation of chronic bronchitis, acute maxillary sinusitis, pharyngitis, or tonsillitis: 300 mg q 12 hr PO for 10 days or 600 mg q 24 hr PO for 10 days.
PEDIATRIC PATIENTS 6 MO–12 YR
  • Otitis media, acute maxillary sinusitis, pharyngitis, tonsillitis: 7 mg/kg q 12 hr PO or 14 mg/kg q 24 hr PO for 10 days up to maximum dose of 600 mg/day.
  • Skin and skin-structure infections: 7 mg/kg PO q 12 hr for 10 days.
PATIENTS WITH RENAL IMPAIRMENT

For creatinine clearance < 30 mL/min, 300 mg PO daily. For patients on dialysis, 300 mg PO every other day; start with 300 mg PO at the end of dialysis and then every other day.

Pharmacokinetics
Route Peak Duration
Oral 60 min 8–10 hr

Metabolism: T1/2: 100 min

Distribution: Crosses the placenta, enters breast milk

Excretion: Renal, unchanged

Adverse effects
  • CNS: Headache, dizziness, lethargy, paresthesias
  • GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudo­membranous colitis, liver toxicity
  • GU: Nephrotoxicity
  • HematologicBone marrow depression
  • Hypersensitivity: Ranging from rash to fever to anaphylaxis; serum sickness reaction
  • Other: Superinfections
Interactions
Drug-drug
  • Increased nephrotoxicity with aminoglycosides
  • Increased bleeding effects if taken with oral anticoagulants
  • Interferes with absorption of cefdinir if taken with antacids containing magnesium or aluminum or with iron supplements; separate by at least 2 hr
Drug-lab test
  • Possibility of false results on tests of urine glucose using Benedict’s solution, Fehling’s solution, Clinitest tablets; urinary 17-ketosteroids; direct Coombs’ test
Nursing considerations
Assessment
  • History: Penicillin or cephalosporin allergy; pregnancy or lactation, renal failure
  • Physical: Kidney function, respiratory status, skin status; culture and sensitivity tests of infected area
Interventions
  • Arrange for culture and sensitivity tests of infected area before beginning drug therapy and during therapy if infection does not resolve.
  • Reconstitute oral suspension by adding 39 mL water to the 60 mL bottle, 65 mL water to the 120 mL bottle; shake well before each use. Store at room temperature. Discard after 10 days.
  • Give drug with meals; arrange for small, frequent meals if GI complications occur. Separate antacids or iron supplements by 2 hr from the cefdinir dose.
  • Arrange for treatment of superinfections if they occur.
Teaching points
  • Take this drug with meals or food. Store suspension at room temperature, shake well before each use; discard any drug after 10 days.
  • Complete the full course of this drug, even if you feel better before the course of treatment is over.
  • This drug is prescribed for this particular infection; do not self-treat any other infection with this drug.
  • You may experience these side effects: Stomach upset, loss of appetite, nausea (taking the drug with food may help); diarrhea (stay near bathroom facilities); headache, dizziness.
  • Report severe diarrhea with blood, pus, or mucus; rash or hives; difficulty breathing; unusual tiredness, fatigue; unusual bleeding or bruising.