What is the treatment for heavy growth of Haemophilus influenzae with Cefdinir (Cefdinir is a brand name, the generic name is Cefdinir, however since it is the same, it will be left as is)?

From the Guidelines

Cefdinir is an appropriate treatment option for heavy growth of Haemophilus influenzae, with a recommended adult dosage of 300 mg twice daily or 600 mg once daily for 10 days, and for children, 14 mg/kg/day divided into one or two doses, not exceeding 600 mg daily, also for 10 days. The effectiveness of cefdinir against H. influenzae, including beta-lactamase producing strains, is due to its classification as a third-generation cephalosporin with good coverage against gram-negative organisms 1.

Key Considerations

• Cefdinir should be taken with food to reduce gastrointestinal side effects.
• Patients should be advised that cefdinir may cause reddish stools when consumed with iron-containing products.
• If symptoms worsen or do not improve within 3 days, the patient should seek medical attention as culture and sensitivity testing may be needed to guide alternative therapy.

Alternative Treatments

• Amoxicillin-clavulanate (875/125 mg twice daily for adults) is an alternative for patients without a cephalosporin allergy.
• Azithromycin (500 mg on day 1, then 250 mg daily for 4 days) or trimethoprim-sulfamethoxazole (160/800 mg twice daily for adults) can be considered for patients with a cephalosporin allergy.

Patient Guidance

• Patients should complete the full course of antibiotics even if symptoms improve before completion.
• Regular follow-up is crucial to monitor the effectiveness of the treatment and to address any potential side effects or complications.

From the FDA Drug Label

To reduce the development of drug-resistant bacteria and maintain the effectiveness of cefdinir and other antibacterial drugs, cefdinir should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria Cefdinir for oral suspension is indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the conditions listed below Adults and Adolescents Community-Acquired Pneumonia caused by Haemophilus influenzae (including β-lactamase producing strains) Acute Exacerbations of Chronic Bronchitis caused by Haemophilus influenzae (including β-lactamase producing strains) Acute Maxillary Sinusitis caused by Haemophilus influenzae (including β-lactamase producing strains) Pediatric Patients Acute Bacterial Otitis Media caused by Haemophilus influenzae (including β-lactamase producing strains)

Treatment of Heavy Growth Haemophilus influenzae with Cefdinir is indicated for mild to moderate infections.

• Key Points:
  • Cefdinir is effective against Haemophilus influenzae (including β-lactamase producing strains)
  • Indicated for Community-Acquired Pneumonia, Acute Exacerbations of Chronic Bronchitis, Acute Maxillary Sinusitis, and Acute Bacterial Otitis Media
  • Should only be used to treat infections caused by susceptible bacteria 2

From the Research

Treatment of Heavy Growth Haemophilus influenzae with Cefdinir

• Cefdinir is an oral third-generation cephalosporin with good in vitro activity against Haemophilus influenzae, including beta-lactamase-producing strains 3, 4, 5.
• The drug has shown good clinical and bacteriological efficacy in the treatment of respiratory tract infections, including those caused by Haemophilus influenzae, in randomized controlled trials 3, 4, 6.
• Cefdinir is stable to hydrolysis by commonly occurring plasmid-mediated beta-lactamases and retains good activity against beta-lactamase-producing strains of H. influenzae 4.
• The susceptibility rates of H. influenzae to cefdinir have been reported to be 97.1 to 99.0% in recent studies 5.
• Cefdinir has been shown to be effective in the treatment of acute bacterial rhinosinusitis, including cases caused by H. influenzae, with efficacy similar to that of other recommended regimens 6.

Mechanism of Action and Resistance

• Cefdinir works by inhibiting cell wall synthesis in bacteria, leading to cell lysis and death 3, 4.
• The mechanism of resistance to cefdinir in H. influenzae is not fully understood, but it is thought to involve a combination of factors, including beta-lactamase production and cell permeability barriers 7.
• Cefdinir is effective against beta-lactamase-producing strains of H. influenzae, but its activity may be reduced against strains with high-level beta-lactamase production 7.

Clinical Use and Efficacy

• Cefdinir is approved for the treatment of a range of infections, including respiratory tract infections, skin and skin structure infections, and acute otitis media 3, 4, 6.
• The drug is generally well tolerated, with a low incidence of adverse events, including diarrhea, which is the most common adverse event reported in clinical trials 3, 4.
• Cefdinir has been shown to be effective in the treatment of infections caused by H. influenzae, including those with heavy growth, with clinical cure rates similar to those of other recommended regimens 3, 4, 6.