Cefdinir + Lactobacillus

Usage

Cefdinir is a third-generation cephalosporin antibiotic indicated for the treatment of various bacterial infections, including:

• Community-Acquired Pneumonia: Caused by susceptible strains of Streptococcus pneumoniae (penicillin-susceptible strains only), Haemophilus influenzae (including beta-lactamase-producing strains), Haemophilus parainfluenzae (including beta-lactamase-producing strains), or Moraxella catarrhalis (including beta-lactamase-producing strains).
• Acute Exacerbations of Chronic Bronchitis: Caused by susceptible strains of H. influenzae, H. parainfluenzae, S. pneumoniae, or M. catarrhalis.
• Acute Maxillary Sinusitis: Caused by susceptible strains of H. influenzae, S. pneumoniae, or M. catarrhalis.
• Pharyngitis and Tonsillitis: Caused by Streptococcus pyogenes.
• Uncomplicated Skin and Skin Structure Infections: Caused by susceptible strains of Staphylococcus aureus (including beta-lactamase-producing strains) or S. pyogenes.
• Acute Otitis Media: Caused by susceptible strains of S. pneumoniae, H. influenzae, M. catarrhalis, or S. pyogenes.

Pharmacological Classification: Cefdinir is a beta-lactam antibiotic belonging to the cephalosporin class.

Mechanism of Action: Cefdinir inhibits bacterial cell wall synthesis by binding to and inactivating penicillin-binding proteins (PBPs). This leads to cell lysis and bacterial death.

Alternate Names

Cefdinir is also known as cefdinir hydrochloride.

Brand Names: Omnicef

How It Works

Pharmacodynamics: Cefdinir exerts its bactericidal effect by disrupting the synthesis of the peptidoglycan layer of bacterial cell walls. This is achieved through binding to PBPs, essential enzymes for cell wall cross-linking. The result is a weakened cell wall, ultimately causing bacterial cell lysis and death.

Pharmacokinetics:

• Absorption: Cefdinir is readily absorbed orally, with peak plasma concentrations occurring 2 to 4 hours after administration. Food may slightly decrease the rate but not the extent of absorption. The bioavailability of the capsule formulation is approximately 21%, while the suspension has an estimated bioavailability of 25%.
• Distribution: Cefdinir distributes widely into various tissues and fluids, including the lungs, sinuses, middle ear fluid, and skin.
• Metabolism: Cefdinir is minimally metabolized in the liver.
• Elimination: Primarily excreted unchanged by the kidneys, with a half-life of approximately 1.7 hours.

Dosage

Standard Dosage

Adults:

• 300 mg every 12 hours or 600 mg once daily for 5 to 10 days for most infections.
• For uncomplicated skin infections, the recommended duration is 10 days.

Children (6 months to 12 years):

• 7 mg/kg every 12 hours or 14 mg/kg once daily, up to a maximum of 600 mg per day, for 5 to 10 days.
• Pediatric patients weighing ≥ 43 kg should receive the maximum daily dose of 600 mg.

Special Cases:

• Elderly Patients: No specific dosage adjustments are generally necessary unless renal function is impaired.
• Patients with Renal Impairment: Dosage adjustment is necessary:
  • Creatinine Clearance (CrCl) < 30 mL/min (adults): 300 mg once daily.
  • CrCl < 30 mL/min (children): 7 mg/kg once daily (up to 300 mg).
• Patients with Hepatic Dysfunction: No dosage adjustment is required.
• Patients with Comorbid Conditions: Dosage adjustments may be needed depending on the specific comorbidity. Consult with a nephrologist if renal function is affected.

Clinical Use Cases Dosage information for specific clinical use cases like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations is not available for Cefdinir from the provided sources. Generally, antibiotic prophylaxis may be employed peri-operatively in certain surgical procedures to prevent surgical site infections, but the choice of antibiotic and dosage regimen depends on various factors such as the type of surgery, patient-specific risk factors, and local antibiogram. Cefdinir is typically not indicated for such prophylactic use.

Dosage Adjustments Dosages should be modified based on CrCl as outlined above.

Side Effects

Common Side Effects:

• Diarrhea
• Nausea
• Abdominal pain
• Vaginal candidiasis
• Headache
• Dizziness

Rare but Serious Side Effects:

• Clostridium difficile-associated diarrhea (CDAD)
• Allergic reactions (ranging from rash to anaphylaxis)
• Serum sickness-like reaction
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis
• Erythema multiforme
• Hepatic dysfunction
• Seizures (rare)

Contraindications

• Known hypersensitivity to cefdinir or other cephalosporins.

Drug Interactions

• Antacids: Concurrent administration with antacids containing aluminum or magnesium can reduce the absorption of cefdinir.
• Iron Supplements: Iron can reduce cefdinir absorption.
• H2-Receptor Antagonists: May decrease cefdinir levels.
• Probenecid: May increase cefdinir serum concentrations.
• Oral Contraceptives: Cefdinir may reduce the effectiveness of oral contraceptives.

Pregnancy and Breastfeeding

• Pregnancy: Cefdinir is classified as Pregnancy Category B. Use with caution during pregnancy and only if clearly needed.
• Breastfeeding: Cefdinir is excreted in breast milk. Caution is advised while breastfeeding.

Drug Profile Summary

• Mechanism of Action: Inhibits bacterial cell wall synthesis.
• Side Effects: Diarrhea, nausea, abdominal pain, headache. Rarely: CDAD, allergic reactions, seizures.
• Contraindications: Hypersensitivity to cephalosporins.
• Drug Interactions: Antacids, iron supplements, H2-receptor antagonists, probenecid.
• Pregnancy & Breastfeeding: Category B; caution advised.
• Dosage: Adults: 300 mg q12h or 600 mg qd; children: 7 mg/kg q12h or 14 mg/kg qd (max 600mg/day).
• Monitoring Parameters: Renal function, signs of superinfection.

Popular Combinations As provided sources do not contain information about popular combination of cefdinir with other drugs, the information requested cannot be provided.

Precautions It should be noted that the available sources provide limited information about the combination medicine Cefdinir + Lactobacillus. Hence, this section focuses on the individual components and their relevant precautions.

• Cefdinir: Assess renal function, monitor for signs of superinfection (e.g., CDAD, candidiasis).
• Lactobacillus: While generally safe, some individuals may experience mild gastrointestinal symptoms. Caution should be used in immunocompromised patients.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Cefdinir?

A: Adults: 300 mg every 12 hours or 600 mg once daily. Children (6 months - 12 years): 7 mg/kg every 12 hours or 14 mg/kg once daily (max 600 mg/day).

Q2: Can Cefdinir be used in patients with penicillin allergies?

A: Caution should be exercised in patients with penicillin allergies, as cross-reactivity can occur. However, it is often considered a suitable alternative for non-anaphylactic penicillin allergies.

Q3: What are the most common side effects of Cefdinir?

A: Diarrhea, nausea, and abdominal pain are the most common side effects.

Q4: Does Cefdinir interact with other medications?

A: Yes, Cefdinir can interact with antacids, iron supplements, and H2-receptor antagonists, among others.

Q5: Can Cefdinir be used during pregnancy and breastfeeding?

A: Cefdinir is a Pregnancy Category B drug. It should be used during pregnancy only if clearly needed. Caution is advised while breastfeeding.

Q6: What should I do if I miss a dose of Cefdinir?

A: Take the missed dose as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.

Q7: How should Cefdinir oral suspension be stored?

A: After reconstitution, store the suspension at room temperature.

Q8: Can Cefdinir be used to treat viral infections?

A: No, Cefdinir is only effective against bacterial infections. It will not work for viral infections like the common cold or flu.

Q9: What is the role of Lactobacillus when combined with Cefdinir?

A: The provided sources lack information about the combined use of cefdinir and Lactobacillus. Generally, probiotics like Lactobacillus are sometimes used to prevent or treat antibiotic-associated diarrhea, but their efficacy varies. It is important to discuss the use of probiotics with a healthcare professional.