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Cefdinir pharmacokinetics and tolerability in children receiving 25 mg/kg once daily

Karen L Bowlware1, George H McCracken, Juanita Lozano-Hernandez

  • 1University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Karen-Bowlware@ouhsc.edu

The Pediatric Infectious Disease Journal
|March 3, 2006
PubMed

Insights

A higher dose of cefdinir (25 mg/kg) is not more effective for treating acute otitis media in children caused by penicillin-nonsusceptible Streptococcus pneumoniae. This dosage may lead to treatment failure and increased side effects like diarrhea.

Area of Science:

  • Pharmacology
  • Pediatrics
  • Infectious Diseases

Background:

  • Cefdinir is an oral cephalosporin used for acute otitis media in children with beta-lactam hypersensitivity.
  • The current 14 mg/kg/day dosage is approved for penicillin-susceptible Streptococcus pneumoniae.

Purpose of the Study:

  • To evaluate if a higher cefdinir dosage (25 mg/kg/day) would be more effective against penicillin-nonsusceptible Streptococcus pneumoniae in children.
  • To assess the pharmacokinetics and pharmacodynamics of different cefdinir dosages.

Main Methods:

  • Pharmacokinetic analysis of 37 infants and children receiving cefdinir at 14 mg/kg or 25 mg/kg once daily for 10 days.
  • Plasma concentrations measured by liquid chromatography.
  • Pharmacodynamics assessed against Streptococcus pneumoniae minimum inhibitory concentrations.

Main Results:

  • Higher cefdinir plasma concentrations and AUC values observed with the 25 mg/kg dose.
  • Pharmacodynamic measures indicated <40% effectiveness over the 24-hour dosing interval for penicillin-nonsusceptible strains.
  • Diarrhea occurred in 20% of subjects receiving the higher cefdinir dosage.

Conclusions:

  • A cefdinir dosage of 25 mg/kg daily is ineffective for treating acute otitis media caused by penicillin-nonsusceptible Streptococcus pneumoniae.
  • The higher dosage did not achieve adequate therapeutic targets for these resistant strains.
Abstract

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