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  • Cefdinir an oral cephalosporin for the treatment of respiratory tract infections and skin and skin structure infections
    Expert Review of Anti-infective Therapy, 2007
    Co-Authors: Helio S Sader, Ronald N Jones
    Abstract:

    Cefdinir is an oral third-generation cephalosporin (also known as an advanced-spectrum or generation cephem) with good in vitro activity against the pathogens responsible for community-acquired respiratory tract infections and uncomplicated skin and skin structure infections. The drug distributes very well in respiratory tract tissues and fluids, as well as skin blisters and ear fluids; its pharmacokinetic profile allows once- or twice-daily administration. Oral Cefdinir 300 mg twice daily or 600 mg once daily in adults and adolescents, or 14 mg/kg/day in one or two daily doses in pediatric patients, administered for 5 or 10 days, has shown good clinical and bacteriological efficacy, at least equivalent to that of other oral agents in randomized controlled trials conducted in patients with community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, sinusitis, acute otitis media, pharyngitis and uncomplicated skin and skin structure infections. Cefdinir is well tolerated and the oral suspension has shown superior taste or palatability over other comparator oral antimicrobial agents. Thus, Cefdinir continues to represent an important cephalosporin option for the treatment of adult, adolescent and pediatric patients with mild or moderate respiratory tract or cutaneous infections, especially in areas with elevated rates of beta-lactamase production in Haemophilus influenzae and where resistance to other commonly used agents has emerged (e.g., macrolides, penicillins, tetracyclines, fluoroquinolones and trimethoprim-sulfamethoxazole).

  • Cefdinir activity against contemporary north american isolates from community acquired urinary tract infections
    International Journal of Antimicrobial Agents, 2005
    Co-Authors: Helio S Sader, Douglas J Biedenbach, Jennifer M Streit, Ronald N Jones
    Abstract:

    Cefdinir is an oral cephalosporin approved by the US Food and Drug Administration in 1997 for the treatment of community-acquired (CA) respiratory tract and uncomplicated skin and soft tissue infections. The objective of the present study was to evaluate the in vitro activity of Cefdinir against recent clinical isolates collected from CA-urinary tract infections (UTIs), a possible expanded indication. A total of 456 isolates from CA-UTI were collected from medical centres in North America (NA; United States and Canada) in 2003 and susceptibility tested by NCCLS reference broth microdilution methods. Cefdinir and cefpodoxime were the most active compounds tested against Escherichia coli (98.7% susceptibility), followed by nitrofurantoin (97.0%) and ciprofloxacin (95.0%). Cefdinir was 8- to 16-fold more potent than cefuroxime axetil and cefprozil against E. coli, Klebsiella spp. and Staphylococcus saprophyticus. The activity of Cefdinir was most similar to that of cefpodoxime against E. coli and Klebsiella spp., but cefpodoxime showed inferior activity against S. saprophyticus. The Cefdinir spectrum was significant superior (+3.8 to 16.5%) to that of trimethoprim/sulphamethoxazole against all pathogens evaluated. The Cefdinir spectrum and potency were comparable or superior to other orally administered beta-lactams tested against recent (2003) clinical isolates from CA-UTI.

  • potency and spectrum reevaluation of Cefdinir tested against pathogens causing skin and soft tissue infections a sample of north american isolates
    Diagnostic Microbiology and Infectious Disease, 2004
    Co-Authors: Helio S Sader, Jennifer M Streit, Thomas R Fritsche, Ronald N Jones
    Abstract:

    Cefdinir is a widely used orally administered cephalosporin for community-acquired respiratory tract infections and skin and soft tissue infections (SSTI). A total of 415 nonduplicate isolates of community-acquired SSTI (CA-SSTI) were collected from medical centers in North America and susceptibility tested against Cefdinir and various compounds indicated for the treatment of CA-SSTI. The Cefdinir MIC(50/90) in microg/mL/% susceptible for strains of the 7 principal CA-SSTI pathogens were: oxacillin-susceptible Staphylococcus aureus (0.5/0.5/100%), oxacillin-susceptible coagulase-negative staphylococci (0.06/0.12/100%), group A streptococci ( or = 4 mg/L). Cefdinir showed a spectrum and potency comparable or superior to other orally administered beta-lactams (cephalexin).

  • contemporary evaluation of the in vitro activity and spectrum of Cefdinir compared with other orally administered antimicrobials tested against common respiratory tract pathogens 2000 2002
    Diagnostic Microbiology and Infectious Disease, 2003
    Co-Authors: Helio S Sader, Thomas R Fritsche, Alan H Mutnick, Ronald N Jones
    Abstract:

    Cefdinir is an oral cephalosporin approved by the Food and Drug Administration in 1997 for the treatment of acute exacerbation of chronic bronchitis, pharyngitis-tonsillitis, community-acquired pneumonia, acute maxillary sinusitis, and uncomplicated skin and skin structure infections in adults and adolescents, and acute otitis media, pharyngitis-tonsillitis, and uncomplicated skin and skin structure infections in children. Although Cefdinir showed similar activity to other cephalosporins in the early studies, very limited data has been generated over the last decade. In this report, we summarize the contemporary in vitro activity and spectrum of Cefdinir in comparison to numerous other orally administrated antimicrobials available for treatment of community-acquired respiratory infections. A total of 8,326 non-duplicate recent clinical isolates, including Haemophilus influenzae (3,438), Moraxella catarrhalis (1,688), and Streptococcus pneumoniae (3,200), were collected from 35 medical centers in North America during 2000 through 2002, and susceptibility tested by reference broth microdilution methods. Pneumococcal susceptibility patterns for beta-lactams and macrolides were also analyzed according to the year of isolation and the age group of the patients. Cefdinir had the greatest activity against H. influenzae among the cephalosporins tested with susceptibility rates of 97.1 to 99.0%. All of the agents tested had complete or near complete activity against M. catarrhalis. Against S. pneumoniae, Cefdinir and other cephalosporins showed similar susceptibility patterns, but improved rates were observed in 2002 (78.5-79.4%) when compared to the previous monitored period (71.8-74.5%). This increase in susceptibility was mainly because of a declining the occurrence of high-level penicillin resistance (MIC >/=2 microg/ml) across all age groups. Macrolide resistance also decreased among S. pneumoniae in 2002 when compared to 2000 through 2001; however, resistance to levofloxacin continued to increase from 0.9% in 2000 to 1.4% in 2002. These results indicate a significant change in emerging beta-lactam resistance patterns (including Cefdinir) with a decrease possibly influenced by greater pneumococcal vaccine use in children and the elderly. These rates of increased susceptibility could sustain and enhance the clinical activity of orally administered beta-lactams such as Cefdinir.

  • predictive accuracy of disk diffusion test for proteus vulgaris and providencia species against five newer orally administered cephalosporins Cefdinir cefetamet cefprozil cefuroxime and loracarbef
    Journal of Clinical Microbiology, 1994
    Co-Authors: Douglas J Biedenbach, Ronald N Jones
    Abstract:

    Three members of the tribe Proteeae (Proteus vulgaris, Providencia rettgeri, and Providencia stuartii) were tested against five newer orally administered cephalosporins (Cefdinir, cefprozil, cefuroxime, cefetamet, and loracarbef) by the disk diffusion and reference broth microdilution methods. One hundred strains of these organisms were tested to confirm the excessive interpretive error rates that previously had been noted for the disk diffusion test. The results indicate that the suggested disk diffusion breakpoints for cefetamet and cefuroxime were without serious interpretive errors. In contrast, loracarbef, Cefdinir, and cefprozil results exceeded acceptable interpretive error rates, with very major (false-susceptible) errors of 4, 5, and 9% respectively. Loracarbef currently has a warning in the National Committee for Clinical Laboratory Standards table footnotes addressing this problem. We recommend including Cefdinir and cefprozil in the list of compounds requiring this warning. In addition, MICs of cefazolin, cefaclor, and cephalothin were determined to establish whether a class MIC concept to predict susceptibility for these agents was possible. When the indole-positive Proteus strains are tested, cefazolin MICs can be used to predict MICs of all tested orally administered cephems (8 to 13% total errors, with only a 0 to 1% very major error.

Helio S Sader - One of the best experts on this subject based on the ideXlab platform.

  • review of the spectrum and potency of orally administered cephalosporins and amoxicillin clavulanate
    Diagnostic Microbiology and Infectious Disease, 2007
    Co-Authors: Helio S Sader, Michael R. Jacobs, Thomas R Fritsche
    Abstract:

    The antimicrobial spectrum and in vitro potency of the most frequently prescribed orally administered cephalosporins (cefaclor, Cefdinir, cefpodoxime, cefprozil, cefuroxime axetil, cephalexin) and amoxicillin/clavulanate are reviewed. These beta-lactam agents have been widely used in the outpatient arena for the treatment of community-acquired respiratory tract and other mild-to-moderate infections. The data presented here were obtained from critical review articles on each of these compounds. Cephalexin and cefaclor were among the least potent and had the narrowest antimicrobial spectrums against the pathogens evaluated. In contrast, Cefdinir, cefpodoxime, cefprozil, and cefuroxime were highly active against penicillin-susceptible Streptococcus pneumoniae and retained some activity against penicillin-intermediate strains, whereas amoxicillin/clavulanate was the most active against S. pneumoniae, including most penicillin nonsusceptible strains. Amoxicillin/clavulanate and Cefdinir were the most potent compounds against methicillin (oxacillin)-susceptible Staphylococcus aureus, whereas cefpodoxime was the most potent compound against Haemophilus influenzae. Amoxicillin/clavulanate, Cefdinir, and cefpodoxime were also active against Moraxella catarrhalis, including beta-lactamase-producing strains. In summary, orally administered "3rd-generation" or extended spectrum cephalosporins exhibited more balanced spectrums of activity against the principal bacterial pathogens responsible for outpatient respiratory tract and other infections when compared with other widely used oral cephalosporins of earlier generations or amoxicillin alone.

  • Cefdinir an oral cephalosporin for the treatment of respiratory tract infections and skin and skin structure infections
    Expert Review of Anti-infective Therapy, 2007
    Co-Authors: Helio S Sader, Ronald N Jones
    Abstract:

    Cefdinir is an oral third-generation cephalosporin (also known as an advanced-spectrum or generation cephem) with good in vitro activity against the pathogens responsible for community-acquired respiratory tract infections and uncomplicated skin and skin structure infections. The drug distributes very well in respiratory tract tissues and fluids, as well as skin blisters and ear fluids; its pharmacokinetic profile allows once- or twice-daily administration. Oral Cefdinir 300 mg twice daily or 600 mg once daily in adults and adolescents, or 14 mg/kg/day in one or two daily doses in pediatric patients, administered for 5 or 10 days, has shown good clinical and bacteriological efficacy, at least equivalent to that of other oral agents in randomized controlled trials conducted in patients with community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, sinusitis, acute otitis media, pharyngitis and uncomplicated skin and skin structure infections. Cefdinir is well tolerated and the oral suspension has shown superior taste or palatability over other comparator oral antimicrobial agents. Thus, Cefdinir continues to represent an important cephalosporin option for the treatment of adult, adolescent and pediatric patients with mild or moderate respiratory tract or cutaneous infections, especially in areas with elevated rates of beta-lactamase production in Haemophilus influenzae and where resistance to other commonly used agents has emerged (e.g., macrolides, penicillins, tetracyclines, fluoroquinolones and trimethoprim-sulfamethoxazole).

  • Cefdinir activity against contemporary north american isolates from community acquired urinary tract infections
    International Journal of Antimicrobial Agents, 2005
    Co-Authors: Helio S Sader, Douglas J Biedenbach, Jennifer M Streit, Ronald N Jones
    Abstract:

    Cefdinir is an oral cephalosporin approved by the US Food and Drug Administration in 1997 for the treatment of community-acquired (CA) respiratory tract and uncomplicated skin and soft tissue infections. The objective of the present study was to evaluate the in vitro activity of Cefdinir against recent clinical isolates collected from CA-urinary tract infections (UTIs), a possible expanded indication. A total of 456 isolates from CA-UTI were collected from medical centres in North America (NA; United States and Canada) in 2003 and susceptibility tested by NCCLS reference broth microdilution methods. Cefdinir and cefpodoxime were the most active compounds tested against Escherichia coli (98.7% susceptibility), followed by nitrofurantoin (97.0%) and ciprofloxacin (95.0%). Cefdinir was 8- to 16-fold more potent than cefuroxime axetil and cefprozil against E. coli, Klebsiella spp. and Staphylococcus saprophyticus. The activity of Cefdinir was most similar to that of cefpodoxime against E. coli and Klebsiella spp., but cefpodoxime showed inferior activity against S. saprophyticus. The Cefdinir spectrum was significant superior (+3.8 to 16.5%) to that of trimethoprim/sulphamethoxazole against all pathogens evaluated. The Cefdinir spectrum and potency were comparable or superior to other orally administered beta-lactams tested against recent (2003) clinical isolates from CA-UTI.

  • potency and spectrum reevaluation of Cefdinir tested against pathogens causing skin and soft tissue infections a sample of north american isolates
    Diagnostic Microbiology and Infectious Disease, 2004
    Co-Authors: Helio S Sader, Jennifer M Streit, Thomas R Fritsche, Ronald N Jones
    Abstract:

    Cefdinir is a widely used orally administered cephalosporin for community-acquired respiratory tract infections and skin and soft tissue infections (SSTI). A total of 415 nonduplicate isolates of community-acquired SSTI (CA-SSTI) were collected from medical centers in North America and susceptibility tested against Cefdinir and various compounds indicated for the treatment of CA-SSTI. The Cefdinir MIC(50/90) in microg/mL/% susceptible for strains of the 7 principal CA-SSTI pathogens were: oxacillin-susceptible Staphylococcus aureus (0.5/0.5/100%), oxacillin-susceptible coagulase-negative staphylococci (0.06/0.12/100%), group A streptococci ( or = 4 mg/L). Cefdinir showed a spectrum and potency comparable or superior to other orally administered beta-lactams (cephalexin).

  • contemporary evaluation of the in vitro activity and spectrum of Cefdinir compared with other orally administered antimicrobials tested against common respiratory tract pathogens 2000 2002
    Diagnostic Microbiology and Infectious Disease, 2003
    Co-Authors: Helio S Sader, Thomas R Fritsche, Alan H Mutnick, Ronald N Jones
    Abstract:

    Cefdinir is an oral cephalosporin approved by the Food and Drug Administration in 1997 for the treatment of acute exacerbation of chronic bronchitis, pharyngitis-tonsillitis, community-acquired pneumonia, acute maxillary sinusitis, and uncomplicated skin and skin structure infections in adults and adolescents, and acute otitis media, pharyngitis-tonsillitis, and uncomplicated skin and skin structure infections in children. Although Cefdinir showed similar activity to other cephalosporins in the early studies, very limited data has been generated over the last decade. In this report, we summarize the contemporary in vitro activity and spectrum of Cefdinir in comparison to numerous other orally administrated antimicrobials available for treatment of community-acquired respiratory infections. A total of 8,326 non-duplicate recent clinical isolates, including Haemophilus influenzae (3,438), Moraxella catarrhalis (1,688), and Streptococcus pneumoniae (3,200), were collected from 35 medical centers in North America during 2000 through 2002, and susceptibility tested by reference broth microdilution methods. Pneumococcal susceptibility patterns for beta-lactams and macrolides were also analyzed according to the year of isolation and the age group of the patients. Cefdinir had the greatest activity against H. influenzae among the cephalosporins tested with susceptibility rates of 97.1 to 99.0%. All of the agents tested had complete or near complete activity against M. catarrhalis. Against S. pneumoniae, Cefdinir and other cephalosporins showed similar susceptibility patterns, but improved rates were observed in 2002 (78.5-79.4%) when compared to the previous monitored period (71.8-74.5%). This increase in susceptibility was mainly because of a declining the occurrence of high-level penicillin resistance (MIC >/=2 microg/ml) across all age groups. Macrolide resistance also decreased among S. pneumoniae in 2002 when compared to 2000 through 2001; however, resistance to levofloxacin continued to increase from 0.9% in 2000 to 1.4% in 2002. These results indicate a significant change in emerging beta-lactam resistance patterns (including Cefdinir) with a decrease possibly influenced by greater pneumococcal vaccine use in children and the elderly. These rates of increased susceptibility could sustain and enhance the clinical activity of orally administered beta-lactams such as Cefdinir.

M E Erwin - One of the best experts on this subject based on the ideXlab platform.

  • interpretive accuracy of the disk diffusion method for testing newer orally administered cephalosporins against morganella morganii
    Journal of Clinical Microbiology, 1993
    Co-Authors: Douglas J Biedenbach, Ronald N Jones, M E Erwin
    Abstract:

    Eight newer orally administered cephems (Cefdinir, cefetamet, cefixime, cefpodoxime, cefprozil, ceftibuten, cefuroxime, and loracarbef) were tested against 100 clinical strains of Morganella morganii to determine the extent of serious interpretive very major (false-susceptible) errors when current criteria for the disk diffusion test are applied. Agar dilution MICs and disk diffusion tests were performed as recommended by the National Committee for Clinical Laboratory Standards (Villanova, Pa.) (NCCLS), and the methods were compared by regression analysis using the method of least squares and by error rate bounding. The following results are listed in the order of increasing error rates: Cefdinir, loracarbef, and cefprozil, < or = 1% very major error; ceftibuten, 8% minor errors; cefuroxime, 21% minor errors; cefixime, cefpodoxime, and cefetamet, very major errors of 15, 24, and 36%, respectively. M. morganii produces unacceptable rates of test error with cefuroxime, cefixime, cefpodoxime, and cefetamet. The latter two cephalosporins currently have NCCLS table footnote warnings covering the problem observed with this organism. The inclusion of cefuroxime and cefixime in the NCCLS table footnote is strongly recommended.

  • disk diffusion quality control guidelines for haemophilus susceptibility tests using Cefdinir ci 960 fleroxacin temafloxacin and trospectomycin
    Journal of Clinical Microbiology, 1992
    Co-Authors: M J Bale, R N Jones, M E Erwin, F P Koontz, E H Gerlach, P. R. Murray, J A Washington
    Abstract:

    A multilaboratory study to determine disk diffusion quality control ranges for Haemophilus influenzae ATCC 49247 and five investigational drugs was performed. Multiple lots of Haemophilus Test Medium and antibiotic disks were used for replicate testing in conformance with the recommendations of the National Committee for Clinical Laboratory Standards. Quality control disk zone diameter ranges were proposed for Cefdinir, CI-960, fleroxacin, temafloxacin, and trospectomycin.

  • Disk Diffusion Quality Control Guidelines for Haemophilus
    1991
    Co-Authors: Clin J. Microbiol, R N Jones, J A Washington, M J Bale, M E Erwin, F P Koontz, E H Gerlach, P. R. Murray
    Abstract:

    trospectomycin. CI-960, fleroxacin, temafloxacin, and Cefdinir,Haemophilus susceptibility tests using Disk diffusion quality control guidelines fo

J A Washington - One of the best experts on this subject based on the ideXlab platform.

Kenneth J Tack - One of the best experts on this subject based on the ideXlab platform.

  • five day Cefdinir course vs ten day cefprozil course for treatment of acute otitis media
    Pediatric Infectious Disease Journal, 2000
    Co-Authors: Stan L Block, James Kratzer, Mary Anne Nemeth, Kenneth J Tack
    Abstract:

    Objective. To compare the clinical efficacy of a 5-day Cefdinir course with a 10-day cefprozil course in the treatment of pediatric acute otitis media (AOM). Design. Comparative, investigator-blinded multicenter trial. Setting. Primary care, ambulatory. Patients. Children ages 6 months through 12 years with clinical symptoms and tympanic membrane signs of AOM, plus tympanometric-confirmed middle ear effusion in at least 1 ear. Of the 435 patients enrolled in the study, 373 were evaluable. Intervention. Patients received Cefdinir 14 mg/kg/day divided twice a day for 5 days or cefprozil 30 mg/kg/day divided twice a day for 10 days. Main outcome measures. Clinical resolution of tympanic membrane signs and symptoms of AOM determined at end of therapy on Study Days 9 to 11. Results. The clinical cure rate at end of therapy was 80% (152 of 190) for Cefdinir-treated patients and 82.5% (151 of 183) for cefprozil-treated patients (95% confidence interval, 10.43% to 5.4%). Diarrhea and overall adverse reactions, respectively, occurred in 7.8 and 13% of Cefdinir-treated patients and in 4.2 and 12% of cefprozil-treated patients. Conclusions. A short course 5-day regimen of Cefdinir was as clinically effective and well-tolerated as a 10-day regimen of cefprozil in the treatment of nonrefractory AOM.

  • Cefdinir versus cefaclor in the treatment of uncomplicated urinary tract infection
    Clinical Therapeutics, 2000
    Co-Authors: Alexander P Leigh, Mary Anne Nemeth, Constance H Keyserling, Leslie H Hotary, Kenneth J Tack
    Abstract:

    Abstract Objective This multicenter, double-blind, randomized, parallel-group study was conducted in Europe, South Africa, and Australia to compare the clinical and microbiologic efficacy and the tolerability of a cephalosporin antibiotic, Cefdinir, with those of cefaclor in the treatment of uncomplicated urinary tract infection. Methods Patients were randomized in a 1:1 ratio to 5 days of treatment with either Cefdinir 100 mg BID or cefaclor 250 mg TID. Results A total of 661 patients were randomized to treatment. They were 90% female, with a median age of 44 years. There were no clinically important differences between groups in terms of demographic characteristics or symptoms on admission. The most frequently isolated pathogens in admission urine cultures were Escherichia coli (383 patients), Proteus mirabilis (20 patients), Staphylococcus saprophyticus (14 patients), and Klebsiella pneumoniae (9 patients). Of the admission pathogens with documented susceptibility results, significantly more were resistant to cefaclor (6.7%) than to Cefdinir (3.7%; P E coli were resistant to cefaclor (5.1%) than to Cefdinir (2.0%; P P = 0.025), mainly due to the greater frequency of diarrhea in the former group. However, only 4 patients (1.2%) discontinued Cefdinir treatment due to diarrhea. Conclusion Empiric therapy with Cefdinir appears to be a reasonable choice for patients with uncomplicated urinary tract infection in whom cephalosporin treatment is indicated.

  • comparison of a 5 day regimen of Cefdinir with a 10 day regimen of cefprozil for treatment of acute exacerbations of chronic bronchitis
    Journal of Antimicrobial Chemotherapy, 2000
    Co-Authors: Charles M Fogarty, Mary Anne Nemeth, Robert B Bettis, Timothy J Griffin, Constance H Keyserling, Kenneth J Tack
    Abstract:

    Patients with acute exacerbations of chronic bronchitis were treated with Cefdinir 300 mg bd for 5 days or cefprozil 500 mg bd for 10 days in a prospective, randomized, double-blind, multicentre study. Of the 548 patients enrolled, 281 (51%) were evaluable. The clinical cure rates at the test-of-cure visit were 80% (114/142) and 72% (100/139) for the evaluable patients treated with Cefdinir and cefprozil, respectively. Respiratory tract pathogens were isolated from 409 (75%) of 548 admission sputum specimens, with the predominant pathogens being Haemophilus parainfluenzae, Haemophilus influenzae, Staphylococcus aureus and Moraxella catarrhalis. The microbiological eradication rates at the test-of-cure visit were 81% (157 of 193 pathogens) and 84% (166 of 198 pathogens) for the evaluable patients treated with Cefdinir and cefprozil, respectively. Adverse event rates while on treatment were equivalent between the two treatment groups. The incidence of diarrhoea during therapy was higher for patients treated with Cefdinir (17%) than for patients treated with cefprozil (6%) (P < 0.01), but most cases were mild and did not lead to discontinuation of treatment. These results indicate that a 5 day regimen of Cefdinir is as effective and safe in the treatment of patients with acute exacerbations of chronic bronchitis as a 10 day regimen of cefprozil.

  • comparative effectiveness and safety of Cefdinir and amoxicillin clavulanate in treatment of acute community acquired bacterial sinusitis Cefdinir sinusitis study group
    Antimicrobial Agents and Chemotherapy, 1997
    Co-Authors: Jack M Gwaltney, W. MICHAEL SCHELD, A Sydnor, C Keyserling, A Leigh, S. Savolainen, P Rivas, P. Schenk, Kenneth J Tack
    Abstract:

    Cefdinir is an extended-spectrum oral cephalosporin that is active against pathogens commonly seen in acute community-acquired bacterial sinusitis (ACABS), including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Two randomized, investigator-blind, multicenter trials (one in the United States and one in Europe) compared two dosage regimens of Cefdinir (600 mg once a day for 10 days and 300 mg twice a day for 10 days) to amoxicillin-clavulanate (A-C) (500 mg three times a day for 10 days) for adult and adolescent patients with ACABS. Twelve hundred twenty-nine patients entered the U.S. study, 698 with antral puncture; 569 patients entered the European study, all with antral puncture. Clinical response (cure or improvement) was determined 7 to 14 days and 3 to 5 weeks posttherapy. Microbiologic eradication rates were determined 10 to 30 days posttherapy in a subset of patients who underwent pre- and posttherapy sinus aspirate culture. Rates of adverse events and treatment discontinuations due to adverse events were examined. Cefdinir, given once or twice daily, was as effective clinically (approximately 90% cure rate) as amoxicillin-clavulanate given three times daily in the treatment of ACABS. Microbiologic eradication rates were also similar in the three groups. The major side effect was mild diarrhea, occurring in approximately 20% of each group. Cefdinir caused fewer adverse events requiring treatment discontinuation.