Cefditoren

Indications

Cefditoren is used for: Pharyngitis, Community-acquired pneumonia, Susceptible infections, Tonsillitis, Soft tissue infections, Respiratory tract infections, Acute Exacerbations of Chronic bronchitis

Adult Dose

Oral Community-acquired pneumonia Adult: 400 mg bid for 14 days. Acute bacterial exacerbation of chronic bronchitis Adult: 400 mg bid for 10 days. Pharyngitis ; Tonsillitis; Uncomplicated skin and skin structure infections Adult: 200 mg bid for 10 days.

Child Dose

<12 years old: Safety & efficacy not established >12 years old: As in adults

Renal Dose

Renal impairment: CrCl (ml/min) 30-49 Maximum: 200 mg bid <30 Maximum: 200 mg once daily

Administration

Should be taken with food.

Contra Indications

Hypersensitivity to Cefditoren, other cephalosporins; or milk proteins. Carnitine deficiency.

Precautions

Pregnancy and lactation. Patients with penicillin allergy. Avoid prolonged use as pivalate-containing compounds may cause carnitine deficiency over time; greater risk of carnitine deficiency in patients with renal impairment or decreased muscle mass. May decrease prothrombin activity especially in patients with renal or hepatic impairment, poor nutritional status, prolonged antibiotic treatment or patients previously stabilised on anticoagulant therapy. Long term use may result in development of drug-resistant bacteria, or superinfection including Clostridium difficile-associated diarrhoea and pseudomembranous colitis. Lactation: excretion in milk unknown; use with caution

Pregnancy-Lactation

Pregnancy Category: B Lactation: excretion in milk unknown; use with caution

Interactions

Reduced oral bioavailability when coadministered with antacids or H2-receptor antagonists. Probenecid may increase plasma concentration and prolong half-life of Cefditoren. May enhance anticoagulant effect of vitamin K antagonists (e.g. warfarin).

Adverse Effects

Side effects of Cefditoren : >10% Diarrhea (11-15%) 1-10% Nausea (4-6%), Headache (2-3%), Abdominal pain (2%), Dyspepsia (1-2%), Vomiting (1%) <1% Bacterial/fungal superinfection, C. difficile colitis, Hypersensitivity, Increased bleeding time, Stevens-Johnson syndrome, Vaginal moniliasis Potentially Fatal: Hypersensitivity, anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis.

Mechanism of Action

Cefditoren is a third generation cephalosporin used for treatment of susceptible infections caused by gram-positive and gram-negative bacteria. It inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs).