Does Omnicef (Cefdinir) treat skin infections?

Omnicef (Cefdinir) for Skin Infections

Yes, Omnicef (cefdinir) is effective for treating uncomplicated skin and skin structure infections, particularly those caused by susceptible strains of Staphylococcus aureus and Streptococcus pyogenes. The FDA has approved cefdinir specifically for this indication 1.

Efficacy for Skin Infections

Cefdinir has demonstrated excellent clinical and microbiological efficacy in treating skin infections:

• In pediatric patients, cefdinir achieved a 99.4% microbiological eradication rate and 98.3% clinical cure rate for skin infections, comparable to cephalexin 2
• Cefdinir penetrates well into skin tissues, with blister fluid penetration of 92.4-108.4%, making it effective for skin infections 3
• As an extended-spectrum, third-generation cephalosporin, it provides good coverage against common skin pathogens including S. aureus and S. pyogenes 4

Dosing for Skin Infections

Adults:

• 300 mg twice daily for 10 days 1

Pediatric patients (6 months through 12 years):

• 7 mg/kg twice daily for 10 days (up to maximum 600 mg daily) 1
• Unlike other indications, skin infections require twice-daily dosing rather than once-daily dosing 1

Important Considerations

1. Pathogen coverage:

   • Effective against methicillin-susceptible S. aureus and S. pyogenes
   • Not effective against MRSA (methicillin-resistant S. aureus)

2. When NOT to use Omnicef:

   • For suspected MRSA infections, guidelines recommend alternative agents such as trimethoprim-sulfamethoxazole, clindamycin, tetracyclines, or linezolid 5
   • For severe or complicated skin infections requiring hospitalization 5, 6

3. Renal adjustment:

   • For adults with creatinine clearance <30 mL/min, reduce dose to 300 mg once daily
   • For pediatric patients with creatinine clearance <30 mL/min/1.73m², reduce dose to 7 mg/kg once daily 1

Alternative Treatments for Skin Infections

According to current guidelines, first-line options for uncomplicated skin infections include:

• For non-MRSA infections: Dicloxacillin, cephalexin, clindamycin, or amoxicillin-clavulanate 5, 6
• For suspected MRSA: Trimethoprim-sulfamethoxazole, doxycycline, minocycline, or clindamycin 5

Clinical Pearls

• Cefdinir can be administered without regard to meals 1
• Most common adverse effect is diarrhea (8% in pediatric patients) 2
• After reconstitution, the oral suspension is stable for 10 days at room temperature 1
• For severe infections or those with systemic symptoms, broader coverage or intravenous therapy may be needed 5, 6

Bottom Line

Omnicef (cefdinir) is an effective treatment for uncomplicated skin infections caused by susceptible organisms. However, in areas with high MRSA prevalence, empiric coverage with agents active against MRSA should be considered until culture results are available.