From the Guidelines
Cefdinir has limited coverage against E. coli, particularly strains producing extended-spectrum beta-lactamases (ESBLs), and its use should be guided by antibiotic susceptibility testing 1. When considering the treatment of infections caused by E. coli, it's crucial to select an antibiotic that is effective against the specific strain. Cefdinir, a third-generation cephalosporin, has been used to treat various bacterial infections, including those caused by E. coli. However, the rise of ESBL-producing E. coli strains has reduced the efficacy of cephalosporins like cefdinir. According to the most recent and highest quality study 1, the use of cefdinir against E. coli is not recommended without prior antibiotic susceptibility testing due to the increasing prevalence of resistance. Some key points to consider when treating E. coli infections include:
- The use of antibiotics with a broader spectrum of activity, such as ticarcillin-clavulanate, cefoxitin, ertapenem, moxifloxacin, or tigecycline, may be more effective against E. coli 1.
- Antibiotic susceptibility testing is essential to ensure the chosen antibiotic is effective against the specific E. coli strain 1.
- The development of antibiotic resistance is a significant concern, and the use of broad-spectrum antibiotics should be guided by local microbiologic data, cost advantage, allergies, and formulary availability 1. It's also important to note that cefdinir is not the first-line treatment for E. coli infections, and other antibiotics like amoxicillin-clavulanate or fluoroquinolones may be more effective in certain cases 1. In summary, while cefdinir may be effective against some strains of E. coli, its use should be guided by antibiotic susceptibility testing and consideration of the potential for resistance, particularly in cases where ESBL-producing strains are suspected 1.
From the FDA Drug Label
Cefdinir exhibits in vitro minimum inhibitory concentrations (MICs) of 1 mcg/mL or less against (≥ 90%) strains of the following microorganisms; however, the safety and effectiveness of cefdinir in treating clinical infections due to these microorganisms have not been established in adequate and well-controlled clinical trials Gram-Negative Bacteria Escherichia coli
Cefdinir may be effective against Escherichia coli (E. coli), as it exhibits in vitro minimum inhibitory concentrations (MICs) of 1 mcg/mL or less against ≥ 90% of strains. However, the safety and effectiveness of cefdinir in treating clinical infections due to E. coli have not been established in adequate and well-controlled clinical trials 2.
From the Research
Cefdinir Coverage Against E. coli
- Cefdinir is an oral third-generation cephalosporin with good in vitro activity against many pathogens commonly causative in community-acquired infections 3, 4, 5.
- However, the provided studies do not specifically mention the effectiveness of cefdinir against E. coli 3, 4, 5.
- One study mentions that all of the beta-lactam regimens had optimal cumulative fraction of response (CFR) against E. coli, but it does not specifically mention cefdinir 6.
- Another study discusses cefiderocol, a different cephalosporin antibiotic, which is effective against E. coli, but this is not relevant to cefdinir 7.