From the Guidelines
Cefdinir is not the preferred treatment for Streptococcus pyogenes infections due to its broad spectrum and higher cost compared to penicillin. When considering treatment for Streptococcus pyogenes infections, also known as strep throat or Group A strep, the primary concern is efficacy, safety, and cost-effectiveness. According to the clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis updated by the Infectious Diseases Society of America in 2012 1, penicillin remains the treatment of choice because of its proven efficacy, safety, narrow spectrum, and low cost. Key points to consider when treating Streptococcus pyogenes infections include:
- Penicillin is the first-line treatment due to its narrow spectrum and proven efficacy, with no documented resistance to date 1.
- Cefdinir, a third-generation cephalosporin, is an option for patients with penicillin allergy, but it is not the preferred choice due to its broad spectrum and higher cost compared to penicillin 1.
- A 10-day course of oral cephalosporin is recommended for most penicillin-allergic individuals, with narrow-spectrum cephalosporins preferred over broad-spectrum cephalosporins like cefdinir 1.
- Cefdinir may be considered for patients with penicillin allergy, but its use should be weighed against the potential risks and benefits, including the selection of antibiotic-resistant flora 1.
From the FDA Drug Label
Pharyngitis/Tonsillitis caused by Streptococcus pyogenes (see CLINICAL STUDIES). NOTE: Cefdinir is effective in the eradication of S. pyogenes from the oropharynx.
Yes, cefdinir will cover Streptococcus pyogenes (strep) infections, specifically for the treatment of pharyngitis/tonsillitis caused by this bacterium 2.
From the Research
Cefdinir Coverage for Streptococcus pyogenes (Strep) Infections
- Cefdinir is effective against Streptococcus pyogenes, with studies showing high eradication rates and clinical cure rates in patients with streptococcal pharyngitis 3, 4, 5.
- A study comparing cefdinir to penicillin V for the treatment of streptococcal pharyngitis found that cefdinir had superior eradication rates and clinical cure rates 3.
- Another study found that a 5-day regimen of cefdinir was as effective as a 10-day regimen of penicillin V in eradicating Streptococcus pyogenes and achieving clinical cure in children with streptococcal pharyngitis 5.
- Cefdinir has a broad spectrum of activity against many gram-negative and gram-positive aerobic organisms, including Streptococcus pneumoniae, Staphylococcus aureus, Streptococcus pyogenes, Haemophilus influenzae, and Moraxella catarrhalis 4, 6.
- However, guidelines recommend using penicillin and amoxicillin as first-line antibiotics for the treatment of streptococcal pharyngitis, with first-generation cephalosporins recommended for patients with nonanaphylactic allergies to penicillin 7.
Key Findings
- Cefdinir is effective against Streptococcus pyogenes, with high eradication rates and clinical cure rates 3, 4, 5.
- Cefdinir can be used as an alternative to penicillin and amoxicillin for the treatment of streptococcal pharyngitis, especially in patients with nonanaphylactic allergies to penicillin 4, 7.
- The choice of antibiotic should be based on patient acceptance, frequency of administration, and cost, as well as local resistance patterns 4, 6.