Cefdinir Versus Cephalexin for the Treatment of Uncomplicated Urinary Tract Infections
Abstract
Background: Due to its low bioavailability and poor urinary penetration, there are concerns that cefdinir is a suboptimal agent for the treatment of urinary tract infections (UTIs). Limited available literature examining cefdinir's use for UTIs has not shown worse outcomes compared with other oral beta-lactams; however, these studies are limited by small sample size or lack of symptom assessment as a measure of clinical cure.
Methods: This retrospective, multicenter cohort study included adult female patients who received either cefdinir or cephalexin for 5-7 days for symptomatic uncomplicated UTI (uUTI). The primary objective was to compare treatment failure, defined as recurrent or continued urinary symptoms necessitating re-treatment within 30 days, between patients treated with oral cefdinir 300 mg twice daily (cefdinir group) and cephalexin 500 mg twice daily (cephalexin group) in the outpatient setting.
Results: Three hundred sixty-seven patients were included (cefdinir n = 167; cephalexin, n = 200). Patients treated with cefdinir experienced a significantly higher rate of treatment failure (23.4% vs 12.5%, P = .006), and cefdinir was independently associated with treatment failure (odds ratio: 1.9 [95% CI: 1.1-3.4]). Additionally, patients who experienced treatment failure with cefdinir had a higher incidence of cefazolin nonsusceptible pathogens (cefdinir 37.5% vs cephalexin 0%; P = .024) and ceftriaxone nonsusceptible pathogens (cefdinir 31.2% vs cephalexin 0%; P =…
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 200 participants or records.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.