CEFDINIR

CEFDINIR (cef'di-nir) Omnicef Classifications: antibiotic; third-generation cephalosporin; Therapeutic: antibiotic; cephalosporin Prototype: Cefotaxime sodium Pregnancy Category: B

Availability

300 mg capsules; 125 mg/5 mL suspension

Action

Broad-spectrum semisynthetic third-generation beta-lactamase cephalosporin antibiotic.

Therapeutic Effect

Effective against a wide variety of gram-positive and gram-negative bacteria.

Uses

Community-acquired pneumonia, acute exacerbations of chronic bronchitis, acute maxillary sinusitis, pharyngitis, tonsillitis, uncomplicated skin infections, bacterial otitis media.

Contraindications

Hypersensitivity to cefdinir and other cephalosporins.

Cautious Use

Hypersensitivity to penicillins, penicillin derivatives; renal impairment; ulcerative colitis or antibiotic-induced colitis; bleeding disorders; GI disorders; liver or kidney disease; pregnancy (category B), lactation. Safety and efficacy in neonates and infants <6 mo old not established.

Route & Dosage

Community-Acquired Pneumonia, Skin Infections Adult: PO 300 mg q12h x 10 d Child (6 mo–12 y): PO 7 mg/kg q12h x 10 d Chronic Bronchitis, Maxillary Sinusitis, Pharyngitis, Tonsillitis Adult: PO 600 mg q24h or 300 mg q12h x 10 d Child (6 mo–12 y): PO 14 mg/kg q24h or 7 mg/kg q12h x 10 d

Administration

Oral

• Do not give within 2 h of aluminum- or magnesium-containing antacids or iron supplements.
• Reconstitute oral suspension to 125 mg/mL by adding water (38 mL to 60 mL bottle or 63 mL to 100 mL bottle). Shake well before each use.
• Consult physician for dosage adjustment if creatinine clearance <30 mL/min and for patients on hemodialysis.
• Store in tightly closed container. Discard after 10 d.

Adverse Effects (≥1%)

GI: Diarrhea, nausea, abdominal pain. Metabolic: Increased GGT, increased urine protein, hematuria. CNS: Headache. Skin: Rash, cutaneous moniliasis. Urogenital: Vaginal moniliasis, vaginitis.

Diagnostic Test Interference

False positive for ketones or glucose in urine using nitroprusside or Clinitest.

Interactions

Drug: antacids should be taken at least 2 h before or after cefdinir; probenecid prolongs cefdinir elimination; iron decreases absorption.

Pharmacokinetics

Absorption: 16–25% bioavailability. Peak: 2–4 h. Distribution: 60–70% protein bound; penetrates sinus tissue, blister fluid, lung tissue, middle ear fluid. Metabolism: Hepatic. Elimination: In urine. Half-Life: 1.6 h.

Nursing Implications

Assessment & Drug Effects

• Determine previous hypersensitivity to cephalosporins, penicillins, and other drug allergies before therapy is initiated.
• Carefully monitor for and immediately report S&S of: hypersensitivity, superinfection, or pseudomembranous colitis (see Appendix F).
• Discontinue drug and notify physician if seizures associated with drug therapy occur.

Patient & Family Education

• Allow a minimum of 2 h between cefdinir and antacids containing aluminum or magnesium, or drugs containing iron.
• Immediately contact physician if a rash, diarrhea, or new infection (e.g., yeast infection) develops.
• Drug may cause false positive for urine ketones or glucose. Consult package insert.

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Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug