Cefdinir
OMNICEF
What it isPBP-inhibiting third-generation oral cephalosporin; otitis and community-acquired pneumonia.
Why this oneBroader Gram-negative cover than cephalexin with once- or twice-daily dosing, and it is well tolerated in children.
What limits itIron and antacids block absorption, and iron turns stools red, which is mistaken for bleeding. No pseudomonal or MRSA cover.
FDA-approved for
- community-acquired pneumonia (1997)
- otitis media (1997)
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Community-acquired pneumonia | Adults/adolescents ≥13 y | 300 mg q12h ×10 days | 300 mg q12h | 600 mg/day |
| Acute exacerbation of chronic bronchitis | Adults/adolescents ≥13 y | 300 mg q12h or 600 mg q24h | 300 mg q12h or 600 mg q24h | 600 mg/day |
| Acute maxillary sinusitis | Adults/adolescents ≥13 y | 300 mg q12h or 600 mg q24h ×10 days | 300 mg q12h or 600 mg q24h | 600 mg/day |
| Pharyngitis/tonsillitis | Adults/adolescents ≥13 y | 300 mg q12h or 600 mg q24h | 300 mg q12h or 600 mg q24h | 600 mg/day |
| Uncomplicated skin/skin-structure infection | Adults/adolescents ≥13 y | 300 mg q12h ×10 days | 300 mg q12h | 600 mg/day |
Renal CrCl <30 mL/min: 300 mg QD. Pediatric CrCl <30 mL/min/1.73m²: 7 mg/kg (max 300 mg) QD. Hemodialysis: 300 mg (or 7 mg/kg) every other day, plus a dose after each session
Hepatic Undefined
Instructions
- May take without regard to meals
- Give twice daily (not once daily) for pneumonia and skin infections
Cautions
- Hypersensitivity/anaphylaxis; cross-reactivity in penicillin-allergic patients
- Pseudomembranous colitis/CDAD
- Seizures reported with cephalosporins, especially in renal impairment
Adverse reactions
- Diarrhea (15%), nausea, headache, abdominal pain
- Vaginal moniliasis/vaginitis
- Rash, dyspepsia, flatulence, vomiting
- Rare: Stevens-Johnson syndrome, hepatic failure, pancytopenia
Pregnancy Category B; not teratogenic in animals; no adequate human studies — use only if clearly needed
Lactation Undefined
NO BOXED WARNINGS
Principal riskHypersensitivity; red stools with iron
Cost, est. cash$5–$150/month
Generic entry2006
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.
Mechanism of action: Cefdinir ballicule
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