Is Cefdinir (Cefdinir) effective against Haemophilus influenzae type b (Hib) and Streptococcus (Strep) infections?

From the Guidelines

Cefdinir is a recommended antibiotic for treating Haemophilus influenzae type b (Hib) and Streptococcus infections, with a calculated bacteriologic efficacy of 86% and 84%, respectively, as shown in a study published in Otolaryngology--head and neck surgery 1.

Key Points

• The recommended dosage for adults is 300 mg twice daily or 600 mg once daily, while children should receive 14 mg/kg/day divided into one or two doses (maximum 600 mg daily) 1.
• Cefdinir works by inhibiting bacterial cell wall synthesis and is particularly effective against these organisms because they typically remain susceptible to third-generation cephalosporins.
• Common side effects include diarrhea, nausea, and rash, and the medication should be taken with or without food, though absorption may be reduced when taken with iron supplements or antacids containing aluminum or magnesium.
• For optimal effectiveness, patients should complete the entire prescribed course even if symptoms improve before finishing the medication.

Considerations

• In areas with high resistance patterns, culture and sensitivity testing may be warranted before initiating therapy 1.
• Cefdinir is highly unlikely to be associated with cross-reactivity with penicillin allergy, making it a suitable option for patients with a history of penicillin allergy 1.
• The choice of antibiotic should be based on the severity of the disease, the patient's history, and the likelihood of resistance, as outlined in the guidelines for acute bacterial rhinosinusitis 1 and community-acquired pneumonia 1.

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 Acute Bacterial Otitis Media caused by Haemophilus influenzae (including β-lactamase producing strains), Streptococcus pneumoniae (penicillin-susceptible strains only), and Moraxella catarrhalis (including β-lactamase producing strains). Pharyngitis/Tonsillitis caused by Streptococcus pyogenes (see CLINICAL STUDIES).

Cefdinir is effective against Haemophilus influenzae (Hib) and Streptococcus pyogenes (strep) in the following conditions:

• Acute Bacterial Otitis Media
• Pharyngitis/Tonsillitis 2

From the Research

Cefdinir for Hib and Strep

• Cefdinir is an oral third-generation cephalosporin with good in vitro activity against many pathogens commonly causative in community-acquired infections, including Haemophilus influenzae (Hib) and Streptococcus pneumoniae (strep) 3.
• The drug provides good coverage against Hib, Moraxella catarrhalis, and penicillin-susceptible Streptococcus pneumoniae, which are common respiratory tract pathogens 3.
• Cefdinir has been shown to be effective in the treatment of streptococcal pharyngitis, with eradication rates of 91.4% and 91.7% in two different dosing regimens, compared to 83.4% with penicillin V 4.
• In another study, cefdinir was found to be superior to penicillin V in the treatment of streptococcal pharyngitis, with a higher rate of clinical cure and eradication of group A beta-hemolytic streptococci (GABHS) 4.
• A 5-day treatment with cefdinir was also found to be safe and effective for the treatment of GABHS pharyngitis, with an eradication rate of 88.5% and a clinical cure rate of 89.0% 5.

Efficacy against Hib and Strep

• Cefdinir has a broad spectrum of activity against many gram-negative and gram-positive aerobic organisms, including Hib and strep 6.
• The drug is stable to hydrolysis by 13 of the common beta-lactamases, which makes it effective against beta-lactamase-producing strains of Hib and other pathogens 3, 6.
• Cefdinir has been shown to be effective in the treatment of various infections, including community-acquired pneumonia, acute bacterial exacerbations of chronic bronchitis, and uncomplicated skin and skin structure infections, which are often caused by Hib and strep 3, 7, 6.

Dosage and Administration

• Cefdinir can be administered once or twice daily, depending on the infection being treated and the patient's age and weight 3, 7, 6.
• The recommended dosage for adults and adolescents is 300 mg twice daily or 600 mg once daily, while pediatric patients can receive 14 mg/kg/day in one or two daily doses 7, 6.