Basic and clinical studies on cefdinir in urology

We studied the antibacterial activity, pharmacokinetics and clinical efficacy of cefdinir (CFDN), a new oral cephalosporin, in the urological field. The results were as follows. 1) Antibacterial activity: We determined the MICs of CFDN against clinical isolates (185 strains of 12 species) from urinary tract infection, and compared them with those of cefaclor (CCL) and ampicillin (ABPC). Against Gram-positive and negative organisms, the overall antibacterial activity of CFDN was superior to those of other antibiotics. CFDN had strong antibacterial activity against Staphylococcus epidermidis, Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis, and moderate activity against Enterococcus faecalis, Proteus vulgalis and Morganella morganii. 2) Pharmacokinetics: The pharmacokinetics was studied using 3 healthy volunteers and 6 patients with impaired renal function. The plasma half-life and urinary excretion of CFDN tended to be prolonged parallel with the decrease in creatinine clearance. 3) Clinical efficacy: In 10 cases of acute uncomplicated cystitis, the overall clinical efficacy rate according to the criteria of the Japanese UTI Committee was 100% and all 12 strains were eradicated bacteriologically. In chronic complicated urinary tract infections, the overall clinical efficacy rate was 79.4% according to the same criteria. Bacteriologically, 37 of 46 strains (80.4%) were eradicated. 4) Side effects: Diarrhea was noted in three patients and soft stool in one, but all cases were mild and transient. No abnormal laboratory findings were observed.