Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1997 Jul;41(7):1579–1583. doi: 10.1128/aac.41.7.1579

Comparison of cefdinir and cefaclor in treatment of community-acquired pneumonia.

M Drehobl 1, P Bianchi 1, C H Keyserling 1, K J Tack 1, T J Griffin 1
PMCID: PMC163963  PMID: 9210689

Abstract

Six hundred ninety patients were enrolled in a multicenter, randomized, double-blind trial comparing the efficacy and safety of cefdinir with those of cefaclor in the treatment of community-acquired pneumonia. Patients received either 10 days of treatment with cefdinir (n = 347) at 300 mg twice daily or 10 days of treatment with cefaclor (n = 343) at 500 mg three times daily. Microbiological assessments were performed on sputum specimens obtained at admission and at the two posttherapy visits, if available. Respiratory tract pathogens were isolated from 538 (78%) of 690 patient admission sputum specimens, with the predominant pathogens being Haemophilus parainfluenzae, Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus. The microbiological eradication rates at the test-of-cure visit were 92% (238 of 260 pathogens) and 93% (245 of 264 pathogens) for the evaluable patients treated with cefdinir and cefaclor, respectively. A satisfactory clinical response (cure plus improvement) was achieved in 89% (166 of 187) and 86% (160 of 186) of the evaluable patients treated with cefdinir and cefaclor, respectively. Except for the incidence of diarrhea, adverse event rates while on treatment were equivalent between the two treatment groups. Diarrhea incidence during therapy was higher for patients treated with cefdinir (13.7%) than for patients treated with cefaclor (5.3%). These results indicate that cefdinir is effective and safe in the treatment of patients with pneumonia.

Full Text

The Full Text of this article is available as a PDF (140.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ashby B. L. Treatment of pneumonia: new strategies for changing pathogens. Clin Ther. 1991 Sep-Oct;13(5):637–650. [PubMed] [Google Scholar]
  2. Bartlett J. G., Mundy L. M. Community-acquired pneumonia. N Engl J Med. 1995 Dec 14;333(24):1618–1624. doi: 10.1056/NEJM199512143332408. [DOI] [PubMed] [Google Scholar]
  3. Bowton D. L., Bass D. A. Community-acquired pneumonia: the clinical dilemma. J Thorac Imaging. 1991 Jul;6(3):1–5. doi: 10.1097/00005382-199107000-00003. [DOI] [PubMed] [Google Scholar]
  4. Breiman R. F., Butler J. C., Tenover F. C., Elliott J. A., Facklam R. R. Emergence of drug-resistant pneumococcal infections in the United States. JAMA. 1994 Jun 15;271(23):1831–1835. [PubMed] [Google Scholar]
  5. Casali L., Voi M., Janssen C. J., Olovich K. G., Dere W. H. Cefaclor advanced formulation versus cefaclor in the treatment of pneumonia. Clin Ther. 1992 Jul-Aug;14(4):570–577. [PubMed] [Google Scholar]
  6. Chien S. M., Pichotta P., Siepman N., Chan C. K. Treatment of community-acquired pneumonia. A multicenter, double-blind, randomized study comparing clarithromycin with erythromycin. Canada-Sweden Clarithromycin-Pneumonia Study Group. Chest. 1993 Mar;103(3):697–701. doi: 10.1378/chest.103.3.697. [DOI] [PubMed] [Google Scholar]
  7. Cohen M. A., Joannides E. T., Roland G. E., Meservey M. A., Huband M. D., Shapiro M. A., Sesnie J. C., Heifetz C. L. In vitro evaluation of cefdinir (FK482), a new oral cephalosporin with enhanced antistaphylococcal activity and beta-lactamase stability. Diagn Microbiol Infect Dis. 1994 Jan;18(1):31–39. doi: 10.1016/0732-8893(94)90131-7. [DOI] [PubMed] [Google Scholar]
  8. Dark D. Multicenter evaluation of azithromycin and cefaclor in acute lower respiratory tract infections. Am J Med. 1991 Sep 12;91(3A):31S–35S. doi: 10.1016/0002-9343(91)90399-i. [DOI] [PubMed] [Google Scholar]
  9. Fang G. D., Fine M., Orloff J., Arisumi D., Yu V. L., Kapoor W., Grayston J. T., Wang S. P., Kohler R., Muder R. R. New and emerging etiologies for community-acquired pneumonia with implications for therapy. A prospective multicenter study of 359 cases. Medicine (Baltimore) 1990 Sep;69(5):307–316. doi: 10.1097/00005792-199009000-00004. [DOI] [PubMed] [Google Scholar]
  10. Farley M. M., Stephens D. S., Brachman P. S., Jr, Harvey R. C., Smith J. D., Wenger J. D. Invasive Haemophilus influenzae disease in adults. A prospective, population-based surveillance. CDC Meningitis Surveillance Group. Ann Intern Med. 1992 May 15;116(10):806–812. doi: 10.7326/0003-4819-116-10-806. [DOI] [PubMed] [Google Scholar]
  11. Garibaldi R. A. Epidemiology of community-acquired respiratory tract infections in adults. Incidence, etiology, and impact. Am J Med. 1985 Jun 28;78(6B):32–37. doi: 10.1016/0002-9343(85)90361-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Gleckman R. A. Pneumonia: update on diagnosis and treatment. Geriatrics. 1991 Feb;46(2):49-50, 55-6. [PubMed] [Google Scholar]
  13. Hyslop D. L. Efficacy and safety of loracarbef in the treatment of pneumonia. Am J Med. 1992 Jun 22;92(6A):65S–69S. doi: 10.1016/0002-9343(92)90610-n. [DOI] [PubMed] [Google Scholar]
  14. Hyslop D. L., Jacobson K., Guerra F. J. Loracarbef (LY163892) versus amoxicillin/clavulanate in bronchopneumonia and lobar pneumonia. Clin Ther. 1992 Mar-Apr;14(2):254–267. [PubMed] [Google Scholar]
  15. Johnson R. H. Community-acquired pneumonia: etiology, diagnosis, and treatment. Clin Ther. 1988;10(5):568–573. [PubMed] [Google Scholar]
  16. Jones R. N., Erwin M. E., Gooding B. B. Interpretive criteria for disk diffusion tests using 5-microgram cefdinir disks with rapidly growing clinical isolates. J Clin Microbiol. 1992 Apr;30(4):1022–1023. doi: 10.1128/jcm.30.4.1022-1023.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Klimek J. J., Ajemian E., Fontecchio S., Gracewski J., Klemas B., Jimenez L. Community-acquired bacterial pneumonia requiring admission to hospital. Am J Infect Control. 1983 Jun;11(3):79–82. doi: 10.1016/0196-6553(83)90117-7. [DOI] [PubMed] [Google Scholar]
  18. Leedom J. M. Pneumonia. Patient profiles, choice of empiric therapy, and the place of third-generation cephalosporins. Diagn Microbiol Infect Dis. 1992 Jan;15(1):57–65. doi: 10.1016/0732-8893(92)90057-z. [DOI] [PubMed] [Google Scholar]
  19. Marrie T. J. Community-acquired pneumonia. Clin Infect Dis. 1994 Apr;18(4):501–515. doi: 10.1093/clinids/18.4.501. [DOI] [PubMed] [Google Scholar]
  20. Niederman M. S., Bass J. B., Jr, Campbell G. D., Fein A. M., Grossman R. F., Mandell L. A., Marrie T. J., Sarosi G. A., Torres A., Yu V. L. Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. American Thoracic Society. Medical Section of the American Lung Association. Am Rev Respir Dis. 1993 Nov;148(5):1418–1426. doi: 10.1164/ajrccm/148.5.1418. [DOI] [PubMed] [Google Scholar]
  21. Poirier R. Comparative study of clarithromycin and roxithromycin in the treatment of community-acquired pneumonia. J Antimicrob Chemother. 1991 Feb;27 (Suppl A):109–116. doi: 10.1093/jac/27.suppl_a.109. [DOI] [PubMed] [Google Scholar]
  22. Williams D., Perri M., Zervos M. J. Randomized comparative trial with ampicillin/sulbactam versus cefamandole in the therapy of community acquired pneumonia. Eur J Clin Microbiol Infect Dis. 1994 Apr;13(4):293–298. doi: 10.1007/BF01974603. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES