Cefdinir (omnicef) - Dosage, side effects & brands

Cefdinir is an oral third generation cephalosporin that inhibits bacterial cell wall synthesis. It has a broad spectrum of activity, especially against enteric gram-negative rods. It is indicated for the treatment of the following conditions:

  • Treatment of acute exacerbations of Chronic obstructive pulmonary disease in adults and adolescents caused by:

    • Haemophilus influenzae including betalactamase- producing strains
    • Haemophilus parainfluenzae including beta-lactamase-producing strains
    • Penicillin-susceptible strains of Streptococcus pneumoniae
    • Moraxella catarrhalis including beta-lactamase-producing strains.
  • Treatment of acute bacterial Otitis media in children caused by:

    • H. influenzae including beta-lactamase-producing strains
    • Penicillin-susceptible strains of S. pneumoniae
    • M. catarrhalis including beta-lactamase-producing strains.
  • Treatment of community-acquired Pneumonia in adults and adolescents caused by:

    • H. influenzae including beta-lactamase-producing strains
    • H. parainfluenzae including beta-lactamase-producing strains
    • Penicillinsusceptible strains of S. pneumoniae
    • M. catarrhalis including beta-lactamase-producing strains
  • Treatment of acute bacterial maxillary sinusitis in adults and adolescents caused by:

    • H. influenzae including beta-lactamase-producing strains
    • Penicillin-susceptible strains of S. pneumoniae
    • M. catarrhalis including beta-lactamase-producing strains.

Note: Cefdinir is not recommended as monotherapy for the empiric treatment in sinusitis.


  • Treatment of Uncomplicated Skin and soft tissue infections caused by:

    • Staphylococcus aureus including beta-lactamase-producing strains
    • Streptococcus pyogenes
  • Treatment of Group A Streptococcal pharyngitis or tonsillitis caused by:

    • Streptococcus pyogenes
  • Adults' acute, simple, and complex urinary tract infections are treated as off-label uses.

Cefdinir Dose in Adults

Cefdinir dosage in exacerbations of Chronic obstructive pulmonary disease:

  • 600 mg orally once a day for five to seven days, or 300 mg twice daily.

Note: According to some specialists, this medication should only be used in patients with simple COPD, which is characterised as having a FEV1 greater than 50% of expected, age less than 65, and fewer frequent exacerbations.


Use in treatment of acute Otitis media (as an alternative agent):

  • For mild to moderate infections, take 300 mg orally twice daily or 600 mg once daily for 5 to 7 days; for severe infections, take 10 days.

Use as an alternative agent in the treatment of community-acquired Pneumonia (pathogen-directed therapy):

Note:

  • 300 mg orally twice a day for a minimum of 5 days
  • Patients should be afebrile for 48 hours or more and clinically stable before therapy is discontinued, otherwise, the duration of therapy may be prolonged.

Cefdinir dose in the treatment of Group A Streptococcal pharyngitis (as an alternative agent):

  • If the penicillin MIC is less than 2 mcg/mL, use solely for Streptococcus pneumoniae-related community-acquired pneumonia.

Off-label use as an alternative agent in the treatment of Urinary tract infections:

Note: It should be Used only when preferred agents not used.

  • Acute uncomplicated cystitis or acute simple cystitis without features of upper urinary tract involvement including prostate and systemic infection:
    • For 5 to 7 days, take 300 mg orally twice every day.
  • Use in the treatment of complicated urinary tract infections including pyelonephritis:
    • For 10 to 14 days, take 300 mg orally twice a day.

Cefdinir Dose in Children

General Cefdinir dosing for susceptible infection:

  • Mild to moderate infections in infants, Children, and Adolescents:
    • 14 mg/kg/day orally, divided into 1–2 doses, with a daily dose cap of 600 mg.

Cefdinir dose in the treatment of acute exacerbation of Bronchitis:

  • Adolescents:
    • 600 mg orally once a day for 10 days, or 300 mg twice daily for 5 to 10 days.

Dose in the treatment of acute Otitis media as an alternative agent:

  • Infants 6 months of age or older and Children:
    • 14 mg/kg/day in one or two divided doses for 5 - 10 days to a maximum daily dose of 600 mg/day.
  • Duration of therapy:
    • If the child is under 2 years old or has significant symptoms, a 10-day treatment is advised (any age)
    • If the child is between the ages of 2 and 5 and has mild to moderate symptoms, a 7-day treatment is advised.
    • If the child is older than 6 years old and exhibiting mild to moderate symptoms, a 5–7 day regimen is advised.

Cefdinir dose in the treatment of Pharyngitis &Tonsillitis:

Note: Cefdinir should not be prescribed for fewer than 10 days.

  • Infants 6 months of age or older and Children:
    • 7 mg/kg/dose orally twice a day for 5 to 10 days or
    • 14 mg/kg/dose orally once a day for 10 days to a maximum daily dose of 600 mg/day.
  • Adolescents:
    • For 5 to 10 days, take 300 mg orally twice day, or for 10 days, take 600 mg orally once daily.

Cefdinir dosage in the treatment of community-acquired Pneumonia:

  • Adolescents:
    • 300 mg orally twice a day for 10 days

Cefdinir dosage for uncomplicated Skin and soft tissue infections:

  • Infants 6 months of age or older and Children:
    • For ten days, administer 14 mg/kg/day orally in two divided doses, with a daily dose cap of 600 mg.
  • Adolescents:
    • 300 mg orally twice a day for 10 days

Cefdinir dosage in the treatment of acute maxillary Sinusitis:

Note: Due to rising resistance, cefdinir should not be used as a sole therapy for the treatment of sinusitis.

  • Infants older than 6 months and Children:
    • 14 mg/kg/day orally in one or two divided doses for 10 days to a maximum daily dose of 600 mg/day.
  • Adolescents:
    • For 10 days, take 300 mg orally twice daily or 600 mg orally once daily.

Pregnancy Risk Factor B

  • Cefdinir can be used safely during pregnancy, as adverse fetal outcomes and teratogenic effects have not been discovered following exposure in the first trimester.

Cefdinir use duringBreastfeeding:

  • Cefdinir cannot be absorbed into breastmilk. 
  • Like all antibiotics, children should be closely monitored for any gastrointestinal problems.

Cefdinir dosage adjustment in Renal disease:

  • CrCl of 30 mL/minute or more:
    • Dosage adjustment is not necessary
  • CrCl of 30 mL/minute or less:
    • 300 mg one time a day orally.
  • ESRD requiring intermittent hemodialysis (IHD): (63% Dialyzable):
    • 300 mg or 7 mg/kg/dose daily orally.
    • Administer the drug post-dialysis on the day of dialysis.

Cefdinir Dose in Liver Disease:

Cefdinir dosage adjustment is not necessary in liver disease. 

Common Side Effects Of Cefdinir Include:

  • Gastrointestinal:
    • Diarrhea

Less Common Side Effects Of Cefdinir Include:

  • Central nervous system:
    • Headache
  • Dermatologic:
    • Skin rash
  • Endocrine & metabolic:
    • Decreased serum bicarbonate
    • Glycosuria
    • Hyperglycemia
    • Hyperphosphatemia
    • Increased gamma-glutamyl transferase
    • Increased lactate dehydrogenase
  • Gastrointestinal:
    • Nausea
    • Abdominal pain
    • Vomiting
  • Genitourinary:
  • Hematologic & oncologic:
    • Lymphocytosis
    • Eosinophilia
    • Lymphocytopenia
    • Abnormal neutrophils
    • Thrombocythemia
  • Hepatic:
    • Increased serum alkaline phosphatase
    • Increased serum ALT
  • Renal:
    • Increased urine pH
    • Increased urine specific gravity

Contraindication to Cefdinir include:

  • Allergy reactions to cefdinir or other cephalosporins or any component of this formulation

Warnings and Precautions

  • Penicillin allergy
    • Cefdinir may cause allergic reactions. Patients with a history or hypersensitivity reaction (like angioedema or urticaria) to penicillins or cephalosporin should not use it.
  • Superinfection
    • Ceftriaxone treatment for longer periods (over 2 months) can lead to superinfections, including fungal or bacterial superinfections. C. difficile-associated diarrhea, (CDAD), and pseudomembranous collitis can occur.
  • Colitis
    • Patients who have had colitis or a history of a gastrointestinal disorder should be cautious about taking the drug.
  • Renal impairment
    • Patients with kidney impairment, especially those with CrCl less than 30mL/minute, should be cautious when using the drug. Dosage adjustment may be necessary.

Monitor:

  • Renal function
  • Observe for features of anaphylaxis during first dose.

How to Administer Cefdinir?

  • Every 12 hours, it is given orally in two evenly divided doses, with or without food.
  • When used with antacids or iron supplements, it should not be done.
  • Before using, the suspension needs to be thoroughly shaken.

Mechanism of action of Cefdinir:

Cefdinir

  • This is a third-generation cephalosporin. It inhibits the formation bacterial proteins and prevents peptidoglycan formation by binding to penicillin-binding protein eventually leading to cell lysis via autolytic enzymes.
  • It is capable of destroying enteric gram-negative rods. ItPermeatesInflammation of the middle ear fluid, tonsils and sinuses, as well as lung tissues, can cause blisters.

60% to 70% of the drug can be found in this categoryprotein-bound.It is minimallyMetabolized. Only 16 to 25% of the drug can be foundbioavailableWhen taken as a suspension or capsule. Thehalf-life eliminationFor patients with normal renal function, it takes approximately 1.7 hours to reach the destination. It takes approximately 1.7 hours to reach the destination.peak plasma concentrationIt takes between 2 and 4 hours. It is primarilyexcretedVia urine

International Brands of Cefdinir:

  • Adcef
  • Addcef
  • Adinir
  • Anicef
  • Anycef
  • Cedenir
  • Cednir
  • Cefdiar
  • Cefnir
  • Cefralin
  • Cefzon
  • Celofarm
  • Danircap
  • Kefnir
  • Maxdinir
  • Medsidin
  • Nilocef
  • Nircef
  • Nirocef
  • Omicef
  • Omnicef
  • Omnicef R
  • Orcef-DS
  • Samnir
  • Sefarin
  • Sefdin
  • Sefdy
  • Torbener

Cefdinir brands in Pakistan:

Cefdinir [Susp 40 mg/5ml]

CEFEYE CARAWAY PHARMACEUTICALS

Cefdinir [Susp 50 mg/5ml]

NIRCEF LOWITT PHARMACEUTICALS (PVT) LTD
XINIR ZANCTOK PHARMACEUTICALS
ZAPLY WILSHIRE LABORATORIES (PVT) LTD.

Cefdinir [Susp 100 mg/5ml]

WNSDINIR WNS FIELD PHARMACEUTICALS

Cefdinir [Susp 125 mg/5ml]

DINACOR HILTON PHARMA (PVT) LIMITED
EFDIR SHROOQ PHARMACEUTICALS
FEDNIR EVEREST PHARMACEUTICALS
NEONIR ENVOY PHARMA
SALUS SUSPENSION OTTOMAN PHARMA
ZAPLY WILSHIRE LABORATORIES (PVT) LTD.

Cefdinir [Susp 250 mg/5ml]

FEDNIR EVEREST PHARMACEUTICALS
SALUS SUSPENSION OTTOMAN PHARMA

Cefdinir [Dry Susp 250 mg/5ml]

EFDIR SHROOQ PHARMACEUTICALS

Cefdinir [Caps 50 mg]

WNSDINIR WNS FIELD PHARMACEUTICALS

Cefdinir [Caps 50 mg]

WNSDINIR WNS FIELD PHARMACEUTICALS

Cefdinir [Caps 250 mg]

NEONIR ENVOY PHARMA

Cefdinir [Caps 300 mg]

DINACOR HILTON PHARMA (PVT) LIMITED
FEDNIR EVEREST PHARMACEUTICALS
NIROCEF AGROR PHARMA
SALUS CAPSULE HIMONT PHARMACEUTICALS (PVT) LTD.
ZAPLY WILSHIRE LABORATORIES (PVT) LTD.

 Cefdinir [Caps 500 mg]

EFDIR SHROOQ PHARMACEUTICALS