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cefdinir

Class: Third-generation cephalosporins. First FDA approval 12/04/1997: 29 years on the US market.

This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.

B

Score breakdown (78/100)

Safety ×35%
A
Evidence ×25%
F
Regulatory ×15%
A
Money & lawsuits ×15%
A
Options ×10%
A

Safety: 100

Evidence: 18

Regulatory history: 93

Money & lawsuits: 100

Options: 100

What the FDA label says

Approved uses

INDICATIONS AND USAGE To reduce the development of drug-resistant bacteria and maintain the effectiveness of cefdinir for oral suspension, USP and other antibacterial drugs, cefdinir for oral suspension, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Cefdinir for oral suspension, USP is indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the conditions listed below. Adults and Adolescents Community-Acquired Pneumonia Caused by Haemophilus influenzae (including β-lactamase producing strains), Haemophilus parainfluenzae (including β-lactamase producing strains), Streptococcus pneumoniae (penicillin-susceptible strains only), and Moraxella catarrhalis (including β-lactamase producing strains) (see CLINICAL STUDIES ). Acute Exacerbations of Chronic Bronchitis C...

Contraindications

CONTRAINDICATIONS Cefdinir for oral suspension is contraindicated in patients with known allergy to the cephalosporin class of antibiotics.

Warnings and precautions

WARNINGS BEFORE THERAPY WITH CEFDINIR FOR ORAL SUSPENSION IS INSTITUTED, CAREFUL INQUIRY SHOULD BE MADE TO DETERMINE WHETHER THE PATIENT HAS HAD PREVIOUS HYPERSENSITIVITY REACTIONS TO CEFDINIR, OTHER CEPHALOSPORINS, PENICILLINS, OR OTHER DRUGS. IF CEFDINIR IS TO BE GIVEN TO PENICILLIN-SENSITIVE PATIENTS, CAUTION SHOULD BE EXERCISED BECAUSE CROSS-HYPERSENSITIVITY AMONG β-LACTAM ANTIBIOTICS HAS BEEN CLEARLY DOCUMENTED AND MAY OCCUR IN UP TO 10% OF PATIENTS WITH A HISTORY OF PENICILLIN ALLERGY. IF AN ALLERGIC REACTION TO CEFDINIR OCCURS, THE DRUG SHOULD BE DISCONTINUED. SERIOUS ACUTE HYPERSENSITIVITY REACTIONS MAY REQUIRE TREATMENT WITH EPINEPHRINE AND OTHER EMERGENCY MEASURES, INCLUDING OXYGEN, INTRAVENOUS FLUIDS, INTRAVENOUS ANTIHISTAMINES, CORTICOSTEROIDS, PRESSOR AMINES, AND AIRWAY MANAGEMENT, AS CLINICALLY INDICATED. Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including cefdinir, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile . C. difficile produces toxins A and B which contribute to the ...

Adverse reactions (label)

ADVERSE EVENTS Clinical Trials Cefdinir for Oral Suspension (Pediatric Patients) In clinical trials, 2289 pediatric patients (1783 U.S. and 506 non-U.S.) were treated with the recommended dose of cefdinir suspension (14 mg/kg/day). Most adverse events were mild and self-limiting. No deaths or permanent disabilities were attributed to cefdinir. Forty of 2289 (2%) patients discontinued medication due to adverse events considered by the investigators to be possibly, probably, or definitely associated with cefdinir therapy. Discontinuations were primarily for gastrointestinal disturbances, usually diarrhea. Five of 2289 (0.2%) patients were discontinued due to rash thought related to cefdinir administration. In the U.S., the following adverse events were thought by investigators to be possibly, probably, or definitely related to cefdinir suspension in multiple-dose clinical trials (N = 1783 cefdinir-treated patients): ADVERSE EVENTS ASSOCIATED WITH CEFDINIR SUSPENSION U.S. TRIALS IN PEDIATRIC PATIENTS (N = 1783) 1 Incidence ≥ 1% Diarrhea 8% Rash 3% Vomiting 1% Incidence < 1% but > 0.1% Cutaneous moniliasis 0.9% Abdominal pain 0.8% Leukopenia 2 0.3% Vaginal moniliasis 0.3% of girls Vagi...

Source: FDA SPL label for Cefdinir (A-S Medication Solutions), effective 20250813. Full label on DailyMed.

Side-effect reports sent to the FDA

These are counts of reports people filed, not rates of harm. Anyone can file one, and nobody checks whether the drug was the cause. Millions of doses are taken for every report sent, so the useful part is how this drug compares with the average across all drugs.

7,720reports that mention this drug
7,711of those blame this drug, not another one the person was taking
60%of reports describe a serious outcome, such as a hospital stay (average for all drugs: 57%)
7.4%of reports include a death, from any cause (average for all drugs: 9.1%)

Problems reported most often

Chronic Kidney Disease · 549Diarrhoea · 500Pneumonia · 492Fatigue · 464Nausea · 405Renal Failure · 398Acute Kidney Injury · 384Sinusitis · 355Headache · 347Pain · 344Urinary Tract Infection · 319Dyspnoea · 315Drug Ineffective · 310Drug Hypersensitivity · 304Off Label Use · 304

Reports per year

20192020202120222023202420252026
1,053980647472453551541266

584 reports blaming this drug for every million Medicare prescriptions filled, which is 0.2× the typical drug on this site. (1,352 reports in 2024–2026, against 2,313,999 Medicare fills in one year. This is the one number here that accounts for how many people take the drug.)

Source: the FDA's Adverse Event Reporting System (FAERS). Reports are voluntary and unverified. Drugs that are prescribed a lot, in the news, or in lawsuits attract more reports, so the percentages are compared with the whole database to correct for that partly, not fully.

Recalls and regulatory record

11recall actions on file
2 / 12brand / generic applications
0label changes since 2021
NoREMS program
DateClassFirmReason
05/2024Class IILupin Pharmaceuticals Inc.Defective container: lack of seal integrity.
04/2024Class IILupin Pharmaceuticals Inc.Presence of foreign substance: Product complaint of foreign material in reconstituted bottle.
04/2024Class IILupin Pharmaceuticals Inc.Presence of foreign substance: Product complaint of foreign material in reconstituted bottle.
07/2020Class IILupin Pharmaceuticals Inc.Superpotent Drug: Out-of-specification (OOS) result observed in an assay test of retention samples.
11/2019Class IIILupin Pharmaceuticals Inc.Presence of Foreign substance: identified as a dead ant.
11/2019Class IIILupin Pharmaceuticals Inc.Presence of Foreign substance: identified as a dead ant.
05/2019Class IILupin Pharmaceuticals Inc.Complaint received of metal piece identified in the product bottle prior to the reconstitution.
01/2019Class IILupin Pharmaceuticals Inc.CGMP Deviations: Product complaints received indicating reconstituted suspension was observed to be thick.
01/2019Class IILupin Pharmaceuticals Inc.CGMP Deviations: Product complaints received indicating reconstituted suspension was observed to be thick.
03/2018Class IILupin Pharmaceuticals Inc.Superpotent Drug
02/2013Class IITeva Pharmaceuticals USA, Inc.Defective Container: This recall is being carried out due to the potential for improperly sealed bottles.

Class I = reasonable probability of serious harm. Class II = temporary or reversible harm. Class III = unlikely to harm. Most generic recalls are manufacturing or labeling defects for one lot, not a verdict on the molecule.

Evidence base

37randomized trials (PubMed)
0systematic reviews
32registered trials
33%of completed trials posted results
6%terminated or withdrawn
59%industry-funded

Counts measure how much evidence exists and how transparent it is, not how big the benefit is. For that, ask your prescriber: if 100 people like me took this, how many would get better because of it, and how many would be harmed? (Doctors call these the "number needed to treat" and "number needed to harm.") It differs by condition and is the number drug ads leave out. Sources: PubMed, ClinicalTrials.gov.

Money and lawsuits

In 2024, drug companies reported $0 in payments to US physicians and hospitals tied to this drug across 0 transactions.

No pending federal MDL names this drug or its brands.

Not named in any federal pharmaceutical settlement of $100M or more on record.

Sources: CMS Open Payments (Sunshine Act); Judicial Panel on Multidistrict Litigation pending docket list; DOJ settlements as tabulated on Wikipedia with links to the primary record. State-court and individual suits are not included.

Who takes it and what it costs

1,855,308Medicare Part D patients (2024)
2,313,999prescriptions filled
$15average cost per fill
$35Mtotal Medicare spend

Same-class alternatives

cefditorencefetametcefiximecefodizimecefoperazonecefotaximecefsulodinceftazidimeceftibutenceftizoximeceftriaxonemoxalactam

Same ATC pharmacological class, graded ones first, best grade at the top. Being in the same class does not make them interchangeable for your condition; it makes them worth asking about.

Questions to ask your prescriber

  1. The most-reported problems in FDA's adverse event data are chronic kidney disease, diarrhoea, pneumonia, fatigue. How would we recognize and handle those?
  2. Why this one over cefditoren, cefetamet, cefixime? What would make you pick one of those instead?
  3. What result are we expecting, by when, and what is the plan if it does not happen?
  4. If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)