Ceftizoxime, Cefdinir, Cefditoren, Cefpodoxime, Ceftibuten, Cefsulodin, and Cefpiramide
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Cefdinir may be used for treatment of upper and lower respiratory tract infections caused by Haemophilus influenzae (including beta-lactamase-producing strains), Streptococcus pneumoniae (penicillin-susceptible strains only), and Moraxella catarrhalis (including beta-lactamase-producing strains) (Bradley et al., 2011). However, according to the IDSA guidelines for acute bacterial rhinosinusitis, cefdinir is no longer recommended as monotherapy for initial empiric treatment (Chow, 2012).
Bloody stool
Alisa McQueen, S. Margaret Paik in Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
This patient was taking cefdinir, an oral cephalosporin, which, in the presence of iron, causes oxidation of the iron and gives an apparently bloody appearance to the stool. This most commonly occurs in infants receiving iron supplements or iron-rich formula.
Population pharmacokinetics and initial dosing regimen optimization of cyclosporin in pediatric hemophagocytic lymphohistiocytosis patients
Published in Xenobiotica, 2020
Dong-Dong Wang, Qiao-Feng Ye, Xiao Chen, Hong Xu, Zhi-Ping Li
The study was approved by the Research Ethics Committee of Children’s Hospital of Fudan University (Ethical code: [2019]021). Pediatric HLH patients (age <16 years) between June 2014 and March 2019 from Children’s Hospital of Fudan University were retrospectively analyzed. Relevant clinical information and drug concentration data were collected from medical records and therapeutic drug monitoring (TDM) records, respectively. Clinical information included gender, dosage form, age, weight, albumin, immunoglobulin, total protein, alanine transaminase, aspartate transaminase, alkaline phosphatase, γ-glutamyltransferase, lactic dehydrogenase, creatinine, urea, uric acid, cystatin-C, direct bilirubin, total bilirubin, hemoglobin, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and drug combinations (compound glycyrrhizin, hexadecadrol, prednisolone, meropenem, omeprazole, compound sulfamethoxazole, cefixime, cefdinir, Piperacillin–Tazobactam, acyclovir, ibuprofen, nadroparin).
Experimental and investigational drugs for the treatment of acute otitis media
Published in Expert Opinion on Investigational Drugs, 2019
Nicola Principi, Susanna Esposito
Administration of systemic antibiotics effective against the most common bacterial causes of AOM is the typical treatment for this disease. Amoxicillin, at the usual (50 mg/kg/day) or increased dosage (80–90 mg/kg/day) according to the sensitivity of Sp in the geographic area where AOM occurs, remains the drug of choice. Amoxicillin-clavulanic acid or cefdinir, cefpodoxime, cefuroxime and ceftriaxone are recommended in children at-risk, in those with previous treatment failure or who have experienced a recent AOM treated with amoxicillin, although apparently healed [7]. However, several reasons suggest judicious antibiotic use in patients with AOM. Up to 80% of AOM cases spontaneously resolve [8], and antibiotics given according to the recommended dosage do not reach bactericidal concentrations in 10%-15% of patients [9], and the use of antibiotics is frequently followed by non-marginal adverse events [10]. Finally, microbial selection and the emergence of resistance to commonly used antibiotics increases with more extensive use of these drugs [11]. All these factors explain why antibiotics are presently recommended only for selected AOM cases. The most recent version of the American Academy of Pediatrics guidelines for the diagnosis and treatment of AOM [7] indicates that treatment is mandatory in all children <2 years with the exception of those with unilateral mild AOM and in those ≥ 2 years with otorrhea or severe symptoms (severe otalgia or otalgia for 48 hours or longer or temperature 39°C or higher). In all the other cases, if parents agree, watchful waiting is preferred, with close follow-up and prescription of antibiotics only when the child worsens or does not improve within 48–72 hours of symptom onset. In general, compliance with these recommendations has led to a significant reduction in antibiotic consumption without medical problems. Unfortunately, compliance is frequently poor, and systemic antibiotics are prescribed more commonly than recommended [12–14].
Unsolved problems and new medical approaches to otitis media
Published in Expert Opinion on Biological Therapy, 2020
Nicola Principi, Susanna Esposito
Although most AOM cases heal spontaneously in a few days, drug therapy in some children is essential to favor AOM resolution and avoid complications. Among these, OME and tympanic membrane perforation (TMP) are the most common. However, very severe clinical problems, such as mastoiditis, meningitis, brain abscess, and facial paralysis, can follow AOM [33]. As AOM is mainly due to bacteria, antibiotics effective against the pathogens that are commonly detected in the middle ear fluid as the cause of disease (Streptococcus pneumoniae, non-typeable (nt) Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes, this last pathogen with wide variations in prevalence according to the geographic area were studies are performed [34–40] are the drugs of choice to treat AOM. However, to avoid antibiotic overuse and related problems, an accurate selection of children with AOM for whom an immediate antibiotic prescription is mandatory is recommended by several scientific societies [34–40]. Antibiotics are generally recommended in severe (moderate to severe otalgia and/or fever ≥39°C) or complicated cases, regardless of patient age and disease laterality. For mild cases, antibiotics are suggested in children aged 6–23 months with bilateral infection. In older children or in children aged 6–23 months with unilateral disease, antibiotic therapy or additional observation are possible choices. The decision depends on the parents/caregiver consent and the activation of a mechanism capable of ensuring follow-up and begin antibiotics if the child worsens or fails to improve within 48 to 72 hours of AOM onset. Considering that S. pneumoniae remains the most common cause of AOM and the aetiologic agent of the most severe cases [41], amoxicillin is indicated as the drug of choice for AOM treatment, eventually with higher-than-usual dosages in those geographic areas where increased minimal inhibitory concentrations (MIC) of amoxicillin for this pathogen have been reported [41]. Use of amoxicillin-clavulanic acid or, in case of penicillin allergy, cefdinir, cefpodoxime, cefuroxime or ceftriaxone, is recommended in subjects who have received amoxicillin in the previous 30 days, in case of failure, in the presence of concurrent purulent conjunctivitis or when there is a history of recurrences that do not respond to amoxicillin. In these cases, AOM is mainly associated with beta-lactamase-producing pathogens, although beta-lactamase-nonproducing strains play a relevant role in some geographic areas [42]. Acetaminophen or ibuprofen is added to treat otalgia and fever. No other selection of AOM cases and no other drug are suggested. However, these guidelines can be debated, as some recent studies seem to indicate that for some AOM cases, a different approach could be followed. The dosages and route of administration of suggested antibiotics can be different from those usually prescribed [35–37] and other pharmacologic measures can play a role in favoring AOM resolution.
Related Knowledge Centers
- Antibiotic
- Otitis Media
- Pneumonia
- Streptococcal Pharyngitis
- Anaphylaxis
- Cellulitis
- Side Effects of Penicillin
- Clostridioides Difficile Infection
- Stevens–Johnson Syndrome
- Pregnancy