Cefdinir
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Trade Name
Omnicef (historical brand name, discontinued in some regions); generic cefdinir
Classification
Third-generation cephalosporin antibiotic; beta-lactam
Dosage/Route
- * Dosage:
- – Capsules: 300 mg
- – Suspension: 125 mg/5 mL, 250 mg/5 mL
- * Route: Oral (PO)
Usual Dosage
- * Adults: 300 mg PO every 12 hours (BID) or 600 mg once daily; max 600 mg/day
- * Children (6 months-12 years): 7 mg/kg PO BID or 14 mg/kg once daily; max 600 mg/day
- * Duration: 5-10 days (e.g., 10 days for strep throat, 5-7 days for sinusitis)
- * Renal impairment (CrCl <30 mL/min): Reduce dose (e.g., 300 mg daily in adults)
Mechanism of Action
Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, disrupting peptidoglycan cross-linking. Bactericidal against gram-positive (e.g., Streptococcus pneumoniae) and gram-negative bacteria (e.g., H. influenzae, M. catarrhalis); broader gram-negative coverage than first/second-generation cephalosporins
Side Effects & Adverse Effects
- * Side Effects: Diarrhea, nausea, rash, headache
- * Adverse Effects:
- – Hypersensitivity (rash, anaphylaxis; ~5-10% cross-reactivity with penicillin allergy)
- – Clostridioides difficile-associated diarrhea (CDAD)
- – Red stools (non-hemorrhagic, with iron in suspension; benign)
- – Rare: Hematologic (e.g., neutropenia), hepatotoxicity
Nursing Management (Implications & Teachings)
- * Implications:
- – Assess for penicillin/cephalosporin allergy (anaphylaxis risk) before first dose
- – Monitor GI symptoms (diarrhea = CDAD risk) and rash (hypersensitivity)
- – Culture/sensitivity before starting if feasible (confirm susceptibility)
- – Give with/without food; avoid antacids/iron within 2 hours (reduce absorption)
- * Teachings:
- – Finish full course; don’t skip doses
- – Report hives, swelling, or severe diarrhea
- – Suspension: Shake well, store at room temp; red stools OK (not blood)
- – Take at consistent times (e.g., 8 AM/8 PM for BID)
Indication for This Patient
* Bacterial infections:
- – Respiratory (e.g., community-acquired pneumonia, sinusitis, bronchitis).
- – Otitis media, pharyngitis (Streptococcus).
- – Skin infections (uncomplicated, e.g., S. aureus, non-MRSA)
Time
- * Timing: Once or twice daily (every 12-24 hours).
- * Onset: Symptom relief in 1-3 days.
- * Duration: 5-10 days (infection-specific)
