Cefdinir Drug Classification
Cefdinir is classified as a third-generation oral cephalosporin antibiotic. 1, 2, 3
Detailed Classification and Characteristics
Cefdinir belongs to the cephalosporin class of antibiotics, specifically:
- It is an extended-spectrum semisynthetic cephalosporin for oral administration 1
- It is categorized as a third-generation cephalosporin 1, 3, 4
- Sometimes referred to as an "advanced-generation" or "advanced-spectrum" cephalosporin 3, 5
Antimicrobial Properties
As a third-generation cephalosporin, cefdinir has specific antimicrobial characteristics:
- Broad-spectrum activity against many gram-positive and gram-negative pathogens 5
- Activity against S. pneumoniae comparable to second-generation agents (e.g., cefuroxime axetil, cefpodoxime proxetil) 1
- Activity against H. influenzae similar to cefuroxime axetil, but lower than cefpodoxime proxetil 1
- Stable to hydrolysis by many common β-lactamase enzymes 2, 4
- Good activity against β-lactamase-producing strains of H. influenzae and M. catarrhalis 4
Pharmacokinetic Properties
Cefdinir has several distinguishing pharmacokinetic features:
- Not appreciably metabolized in the body 1, 2
- Eliminated principally via renal excretion 1, 2
- Pharmacokinetic profile allows for once- or twice-daily dosing 3, 4
- Well-distributed into respiratory tract tissues and fluids 3, 4
- Terminal half-life of approximately 1.5-2.2 hours 2, 5
Clinical Applications
As a third-generation cephalosporin, cefdinir is indicated for:
- Respiratory tract infections (community-acquired pneumonia, acute bacterial exacerbations of chronic bronchitis, sinusitis) 3, 5
- Upper respiratory infections (pharyngitis/tonsillitis, acute otitis media) 1, 4
- Uncomplicated skin and skin structure infections 3, 5
Differences from Other Cephalosporins
Understanding cefdinir's position within the cephalosporin class:
- Unlike first-generation cephalosporins (cephalexin, cefadroxil), cefdinir has good coverage for H. influenzae 1
- More active against gram-positive organisms than some other third-generation agents like cefixime 1, 6
- Unlike cefixime and ceftibuten (other third-generation oral cephalosporins), cefdinir has adequate activity against S. pneumoniae 1
- Generally well-tolerated with the suspension formulation being well-accepted among children 1
Clinical Considerations
When considering cefdinir as a therapeutic option:
- It is an alternative treatment for penicillin-allergic patients, as cross-reactivity between penicillins and third-generation cephalosporins is negligible 1
- Dosage adjustment is required in patients with markedly compromised renal function (creatinine clearance <30 mL/min) 2
- Elderly patients generally do not require dosage adjustment unless they have markedly compromised renal function 2
Cefdinir represents an important oral cephalosporin option for treating mild to moderate bacterial infections, especially in areas with elevated rates of β-lactamase production in common pathogens 3.