From the Guidelines
Cefdinir is not the preferred treatment for Streptococcus pneumoniae bacteremia of pulmonary origin. For adults, the recommended treatment is typically intravenous ceftriaxone (1-2 grams every 12-24 hours) or cefotaxime (1-2 grams every 8 hours) for 10-14 days, whereas for outpatient treatment, oral amoxicillin-clavulanate (500-875mg every 8-12 hours) or levofloxacin (500-750mg every 24 hours) may be considered 1.
Key Points
- Cefdinir may be used as an alternative for mild cases of community-acquired pneumonia, but its use in bacteremia is not recommended due to concerns about penetration and efficacy.
- The choice of antibiotic should be guided by susceptibility testing and local resistance patterns.
- Combination therapy with a macrolide and a beta-lactam may be considered for patients with severe pneumonia or those at risk for resistant organisms.
- Fluoroquinolones, such as levofloxacin, may be used as an alternative for patients who are allergic to penicillin or cephalosporins.
Treatment Considerations
- The treatment of Streptococcus pneumoniae bacteremia should be individualized based on the patient's clinical presentation, underlying health status, and susceptibility testing.
- Patients with severe pneumonia or those at risk for resistant organisms may require broader-spectrum antibiotic coverage.
- The use of vancomycin or linezolid may be considered for patients with severe pneumonia or those who are allergic to other antibiotics.
- It is essential to monitor patients for signs of treatment failure or resistance and adjust the antibiotic regimen as needed.
From the FDA Drug Label
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 Adults and Adolescents Community-Acquired Pneumonia caused by Haemophilus influenzae (including β-lactamase producing strains), Haemophilus parainfluenzae (including β-lactamase producing strains), Streptococcus pneumoniae (penicillin-susceptible strains only), and Moraxella catarrhalis (including β-lactamase producing strains)
The answer is: No, cefdinir can be used to treat Streptococcus pneumoniae infections, but only for Community-Acquired Pneumonia caused by penicillin-susceptible strains of Streptococcus pneumoniae. There is no information that directly supports the use of cefdinir for the treatment of Streptococcus pneumoniae bacteremia of pulmonary origin. 2
From the Research
Cefdinir for Streptococcus pneumoniae Bacteremia
- Cefdinir has good in vitro activity against many pathogens commonly causative in community-acquired infections, including penicillin-susceptible Streptococcus pneumoniae 3, 4.
- The drug provides good coverage against Haemophilus influenzae, Moraxella catarrhalis, and penicillin-susceptible Streptococcus pneumoniae, which are the most common respiratory tract pathogens 3.
- Cefdinir is stable to hydrolysis by commonly occurring plasmid-mediated beta-lactamases and retains good activity against beta-lactamase-producing strains of H. influenzae and M. catarrhalis 3, 4.
Efficacy in Respiratory Tract Infections
- Cefdinir has shown good clinical and bacteriological efficacy in the treatment of a wide range of mild-to-moderate infections of the respiratory tract and skin in adults, adolescents, and pediatric patients in randomized, controlled trials 3, 4.
- Cefdinir is an effective treatment for both lower (acute bacterial exacerbations of chronic bronchitis, community-acquired pneumonia) and upper (acute bacterial rhinosinusitis, streptococcal pharyngitis) respiratory tract infections, and uncomplicated skin infections 3, 4.
Limitations and Considerations
- There is no direct evidence in the provided studies that specifically addresses the use of cefdinir for treating Streptococcus pneumoniae bacteremia of pulmonary origin.
- However, based on its efficacy against penicillin-susceptible Streptococcus pneumoniae and its use in treating community-acquired pneumonia, cefdinir may be considered as an option for treating Streptococcus pneumoniae infections, including bacteremia of pulmonary origin, in certain cases 3, 4.