Update on the cefdinir spectrum and potency against pathogens isolated from uncomplicated skin and soft tissue infections in North America: are we evaluating the orally administered cephalosporins correctly?

The spectrum and potency of cefdinir, an orally administered cephalosporin, was reevaluated for the uncomplicated skin and soft tissue infection (uSSTI) indication using contemporary isolates from 2004 to 2005. Cefdinir continues to have high rates of susceptibility against methicillin-susceptible staphylococci (100.0%), beta-hemolytic streptococci (groups A and B; 100.0%), viridans group streptococci (88.9%), Escherichia coli (93.2%), and Klebsiella pneumoniae (90.0%). No diminished activity was detected since the last evaluation (1997-2002 isolates), and cefdinir remains significantly more potent (4- to 16-fold) than cephalexin, even when using surrogate agents of cephalexin susceptibility that were suspect for estimating true clinical utility. Activity greater than cephalexin (4-fold) was also noted for cefdinir against community-associated methicillin-resistant Staphylococcus aureus isolates. Cefdinir should be considered as a viable option for the therapy uSSTI caused by indicated species.