Patients discharged from the ED with UTIs have similar treatment failure rates with cefpodoxime or cefdinir.

Patients discharged from the ED with UTIs have similar treatment failure rates with cefpodoxime or cefdinir.

View abstract Objectives:To determine trends and predictors of cefdinir use for common pediatric infections in the United States.Design:Retrospective cohort study, 2016–2023.Setting:U.S. outpatient encounters (ambulatory, emergency department, urgent care) included in the Medicaid MarketScan database.Patients:Children aged 0–18 years diagnosed with bacterial rhinosinusitis, pharyngitis, urinary tract infection (UTI), acute otitis media (AOM), or community-acquired pneumonia (CAP).Methods:We assessed cefdinir prescription rates by diagnosis and year, comparing to other commonly administered antibiotics. We used logistic regression to identify demographic predictors of cefdinir use.Results:Among 7,346,547 encounters, most common diagnoses were AOM (36.9%) and bacterial pharyngitis (36.2%). Patients were predominantly non-Hispanic White (53.0%), 1–5 years-old (41.1%), and seen in ambulatory settings (75.3%). Cefdinir was prescribed in 10.4% of encounters, ranking among the top prescribed antibiotics. After an initial increase, use declined post-2020 to 7.6%. In children 1–18 years-old, younger age was uniformly associated with higher odds of cefdinir prescription across all diagnoses. This pattern was inconsistent among infants <1 years-old across diagnoses but persisted for UTI, with ORs of 9.38 (95% CI, 8.91–9.88) for <1 years-old and 5.91 (95% CI, 5.76–6.06) for 1–5 years-old versus 15–18 years-old patients. NH Black patients and those seen in urgent care or the emergency department were less likely to receive cefdinir.Conclusions:Despite a small decline in use since 2020, cefdinir use remains substantial, especially among young children with UTI. Continued efforts to reduce inappropriate use and promote antibiotic stewardship are warranted.

Multidrug-resistant (MDR) bacteria pose a critical global health threat, urgently requiring solutions. Cefdinir, the highest-selling third-generation cephalosporin but one now facing clinical obsoles...

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There is a growing body of evidence supporting early transition to oral antibiotic therapy to complete treatment courses for gram-negative bloodstream infections (GN-BSI) (1–3). Most available data fo...