Cefditoren

General

• Type: Third generation cephalosporin
• Dosage Forms: tablet
• Dosage Strengths: 200, 400mg
• Routes of Administration: PO
• 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

• Anaphylaxis
• Serum-sickness like reaction
• Stevens-Johnson syndrome
• Erythema multiforme
• Toxic epidermal necrolysis
• Leukopenia
• Neutropenia
• Thrombocytopenia
• Anemia, hemolytic
• Seizure
• Nephrotoxicity
• Cholestatic jaundice
• C. difficle-associated diarrhea
• Super infection
• Carnitine deficiency (long-term use)

Common

• Diarrhea
• Nausea
• Headache
• Abdominal pain
• Candidiasis, vulvovaginal
• Dyspepsia

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

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

• Antibiotics (Main)