cefdinir and Haemophilus-Infections

Acute bacterial rhinosinusitis is a common infection resulting in substantial morbidity. Cefdinir, an oral cephalosporin, has extended-spectrum, bactericidal activity against common acute bacterial rhinosinusitis pathogens, including Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Cefdinir shows rapid oral absorption and good respiratory tissue penetration, and may be administered once daily. In randomised clinical trials, cefdinir showed efficacy similar to that of other recommended regimens in the treatment of acute bacterial rhinosinusitis, namely amoxicillin/clavulanate and levofloxacin. Cefdinir is well tolerated and has shown a low propensity to suppress the normal commensal flora. Cefdinir oral suspension is rated highly by children in terms of its taste and smell. As the only once-daily beta-lactam currently recommended by acute bacterial rhinosinusitis guidelines (for first-line use in patients with mild acute bacterial rhinosinusitis and no recent antibacterial use), cefdinir offers a convenient and attractive treatment option.

Topics: Acute Disease; Administration, Oral; Anti-Infective Agents; Cefdinir; Cephalosporins; Drug Administration Schedule; Haemophilus Infections; Haemophilus influenzae; Humans; Moraxella catarrhalis; Moraxellaceae Infections; Pneumococcal Infections; Randomized Controlled Trials as Topic; Sinusitis; Streptococcus pneumoniae

Congenital deformities of the labyrinth of the inner ear can be associated with meningitis and varying degrees of hearing loss or deafness. A recurrence of meningitis is due to the development of a fistulous communication between the subarachnoid space and the middle ear cavity, and can prove lethal. An illustrative case of a 4-year-old Japanese girl with bilateral severe hearing loss, recurrent meningitis and malformations of the inner ear and stapes footplate is presented. Removal of the stapes during tympanotomy provoked a gush of cerebrospinal fluid. The defect was repaired successfully, and there has been no further episodes of meningitis to date.

Topics: Anti-Infective Agents; Cefdinir; Cephalosporins; Cerebrospinal Fluid Otorrhea; Child, Preschool; Cochlea; Ear Diseases; Ear, Inner; Female; Fistula; Haemophilus Infections; Hearing Disorders; Humans; Meningitis, Bacterial; Recurrence; Tomography, X-Ray Computed; Tympanic Membrane

Cefdinir (FK482), a new oral cephalosporin, displayed potent oral activity versus induced infections in mice. In studies using beta-lactamase-nonproducing (beta LAC-) and -producing (beta LAC+) Staphylococcus aureus strains, respective PD50s (in mg/kg) were 11 and 24 for preventing subcutaneous abscess and 2.7 and 2.3 for preventing lethal systemic infection. In studies using beta LAC- and beta LAC+ Haemophilus influenzae, respective PD50s were 5.8 and 3.1 for preventing lethal systemic infection. Time-kill studies versus H. influenzae showed that 6- to 12-mg/kg dosing was effective in reducing viable counts of these strains in blood by > or = 100-fold by 24 h after challenge. This in vivo performance was comparable to or exceeded values generated by cefaclor, cefpodoxime proxetil, and ampicillin.

Topics: Administration, Oral; Animals; beta-Lactamases; Cefdinir; Cephalosporins; Female; Haemophilus Infections; Haemophilus influenzae; Mice; Microbial Sensitivity Tests; Staphylococcal Infections; Staphylococcus aureus