From the Guidelines
Alternatives to cefdinir include amoxicillin-clavulanate, azithromycin, clarithromycin, or doxycycline, depending on the infection being treated, as these options have shown efficacy in treating various bacterial infections, including respiratory and skin infections, as noted in studies such as 1. When considering alternatives to cefdinir, it's essential to take into account the specific infection being treated, as well as local resistance patterns, patient allergies, and comorbidities.
- For respiratory infections like sinusitis or bronchitis, amoxicillin-clavulanate 875/125 mg twice daily for 7-10 days is often an effective substitute, as it has been shown to be effective against a range of bacterial pathogens, including Streptococcus pneumoniae and Haemophilus influenzae, as indicated in 1 and 1.
- For patients with penicillin allergies, azithromycin 500 mg on day 1 followed by 250 mg daily for 4 more days or clarithromycin 500 mg twice daily for 7-14 days can be used, as these macrolides have been shown to be effective against a range of bacterial pathogens, including atypical bacteria like Mycoplasma pneumoniae and Chlamydophila pneumoniae, as noted in 1.
- For skin infections, clindamycin 300-450 mg four times daily for 7-10 days may be appropriate, as it has been shown to be effective against a range of bacterial pathogens, including Staphylococcus aureus and Streptococcus pyogenes, as indicated in 1. These alternatives work through different mechanisms, with beta-lactams like amoxicillin-clavulanate disrupting bacterial cell wall synthesis, and macrolides like azithromycin inhibiting bacterial protein synthesis.
- Side effects vary between medications, with gastrointestinal disturbances being common across most options, so selecting an alternative should consider the patient's tolerance history, as noted in 1 and 1. It's also important to note that the choice of alternative antibiotic should be guided by local resistance patterns and susceptibility testing, as well as patient-specific factors like allergies and comorbidities, as emphasized in 1.
From the FDA Drug Label
CLINICAL STUDIES Community-Acquired Bacterial Pneumonia In a controlled, double-blind study in adults and adolescents conducted in the U.S., cefdinir BID was compared with cefaclor 500 mg TID. In a second controlled, investigator-blind study in adults and adolescents conducted primarily in Europe, cefdinir BID was compared with amoxicillin/clavulanate 500/125 mg TID Streptococcal Pharyngitis/Tonsillitis In four controlled studies conducted in the United States, cefdinir was compared with 10 days of penicillin in adult, adolescent, and pediatric patients.
The alternatives to Cefdinir are:
- Cefaclor: as seen in the community-acquired bacterial pneumonia study 2
- Amoxicillin/Clavulanate: as seen in the European community-acquired pneumonia study 2
- Penicillin: as seen in the streptococcal pharyngitis/tonsillitis studies 2
From the Research
Alternatives to Cefdinir
The following alternatives to Cefdinir are available:
- Amoxicillin/clavulanic acid 3, 4, 5, 6
- Cefprozil 3, 4, 7
- Cefuroxime axetil 3
- Cefaclor 3
- Cefalexin 3, 4, 5
- Loracarbef 3
- Penicillin V (phenoxymethylpenicillin) 3, 4, 5
- Clarithromycin 6
- Azithromycin 6
- Cefpodoxime 6
Spectrum of Activity
These alternative antibiotics have a broad spectrum of activity against many gram-negative and gram-positive aerobic organisms, including:
- Streptococcus pneumoniae 3, 4, 5, 7, 6
- Haemophilus influenzae 3, 4, 5, 7, 6
- Moraxella catarrhalis 3, 4, 5, 7, 6
- Staphylococcus aureus 4
- Streptococcus pyogenes 4
Clinical Efficacy
These alternative antibiotics have shown good clinical and bacteriological efficacy in the treatment of various infections, including: