Cefditoren

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General

  • Type: Third generation cephalosporin
  • Dosage Forms: Tablet 200,400 mg
  • Common Trade Names: Spectracef

Adult Dosing

Chronic Bronchitis, Acute bacterial exacerbation

  • 400 mg PO bid x10 days

Pneumonia, community-acquired

  • 400 mg PO bid for at least 5 days
    • May D/C after five days if afebrile x48-72 hours

Pharyngitis/Tonsillitis, streptococcal

  • 200mg PO bid x10 days

Skin infection

  • 200 mg PO bid x10 days

Pediatric Dosing

12+ yo, Chronic Bronchitis, Acute bacterial exacerbation

  • 400 mg PO bid x10 days

12+ yo, Pneumonia, community-acquired

  • 400 mg PO bid x14 days

12+ yo, Pharyngitis/Tonsillitis, streptococcal

  • 200mg PO bid x10 days

12+ yo, Skin infection

  • 200 mg PO bid x10 days

Special Populations

  • Pregnancy Rating: B; May use during pregnancy
  • Lactation: May use while breastfeeding
  • Renal Dosing
    • Adult
      • CrCl 30-49: Max 200mg bid
      • CrCl <30: Max 200mg qd
      • ESRD/HD: Not defined
    • Pediatric
      • CrCl 30-49: Max 200mg bid
      • CrCl <30: Max 200mg qd
      • ESRD/HD: Not defined
  • Hepatic Dosing
    • Adult
      • Child-Pugh Class A or B: No adjusment
      • Child-Pugh Class C: Not defined
    • Pediatric
      • Child-Pugh Class A or B: No adjusment
      • Child-Pugh Class C: Not defined

Contraindications

  • Allergy to class/drug
  • Hypersensitivity to milk proteins
  • Carnitine deficiency
  • Caution:
    • Hypersensitivity to PCN
    • Renal impairment
    • Decreased muscle mass
    • Recent abx-associated colitis

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 1.6h; 4.7h in severe renal impairment
  • Metabolism: Minimal
  • Excretion: Urine primarily
  • Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium X1
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis I
C. jeikeium X1
L. monocytogenes R
Gram Negatives N. gonorrhoeae S
N. meningitidis X1
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp R
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris I
Providencia sp. X1
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus X1
Citrobacter sp. S
Aeromonas sp X1
Acinetobacter sp. X1
Pseudomonas aeruginosa R
Burkholderia cepacia X1
Stenotrophomonas maltophilia X1
Yersinia enterocolitica X1
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida S
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp X1
Mycoplasm pneumoniae X1
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis X1
Prevotella melaninogenica X1
Clostridium difficile X1
Clostridium (not difficile) X1
Fusobacterium necrophorum X1
Peptostreptococcus sp. X1

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. Sanford Guide to Antimicrobial Therapy 2014