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Evaluation of the Appropriateness of Pediatric Cefdinir Prescribing

Karina Phang1,2, Hannah Anderson2, Aleena Moin3

  • 1Department of Pediatrics, Geisinger Medical Center, Danville, PA, USA.

Clinical Pediatrics
|August 8, 2026
PubMed

Insights

Over half of cefdinir prescriptions for children were inappropriate, particularly in urgent care and when prescribed by non-pediatric specialists. This highlights a need for improved antibiotic stewardship in pediatric care.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Health Services Research

Background:

  • Cefdinir is a commonly prescribed antibiotic for pediatric infections.
  • Appropriate antibiotic use is crucial to combat antimicrobial resistance.
  • Variations in prescribing patterns exist across different healthcare settings and provider types.

Purpose of the Study:

  • To evaluate the appropriateness of cefdinir prescribing in pediatric patients within an integrated healthcare system.
  • To identify factors associated with potentially inappropriate cefdinir prescriptions.

Main Methods:

  • Cross-sectional analysis of 93,748 cefdinir prescriptions for children aged 0-17 years from 2005-2020.
  • Included diagnoses: acute otitis media, sinusitis, streptococcal pharyngitis, community-acquired pneumonia, urinary tract infection, and viral respiratory tract infections.
  • Compared inappropriate prescribing rates by location, provider specialty, and provider type using chi-square tests.

Main Results:

  • 57% (53,642/93,748) of cefdinir prescriptions were deemed potentially inappropriate.
  • Inappropriate prescribing was more common in emergency and urgent care settings compared to ambulatory settings (P < .001).
  • Non-pediatric-trained providers and advanced practice providers were more likely to issue inappropriate cefdinir prescriptions compared to pediatric-trained providers and physician providers, respectively (P < .001).

Conclusions:

  • A significant proportion of pediatric cefdinir prescriptions are potentially inappropriate.
  • Prescribing practices vary by clinical setting and provider training.
  • Interventions targeting provider education and practice setting may improve cefdinir prescribing appropriateness.

Keywords:
acute respiratory tract infectionantibiotic stewardshipcefdinirupper respiratory tract infectionurinary tract infection

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