Azithromycin (Zithromax) vs Cefdinir (Omnicef)
Based on "Antibiotic and Chemotherapy"
written by Roger G. Finch
Azithromycin advantages over Cefdinir
- Unlike cefdinir, azithromycin has excellent activity against atypical bacteria.
- Generic azithromycin is less expensive than cefdinir.
Cefdinir advantages over Azithromycin
- Cefdinir is very effective against penicillin-sensitive Pneumococcus and methicillin-sensitive Staphylococcus aureus.
- Cefdinir suspension has good taste and smell.
|• Macrolide||• Cephalosporin, 3rd-generation|
• Powder for solution
• Oral suspension
• Oral suspension
|• Acute otitis media
• Acute exacerbations of chronic bronchitis
• Community-acquired pneumonia
• Skin and skin structure infections (uncomplicated)
|• Urethritis and cervicitis
• Genital ulcer disease
• Gonococcal infections
• Lyme disease
|• Acute uncomplicated cystitis|
|Mechanism of action|
|• Azithromycin inhibits bacterial protein synthesis.
• Its action is mainly bacteriostatic.
|• Cefdinir inhibits bacterial cell wall synthesis.
• Its action is mainly bactericidal.
|• 40 hours||• 1.5 hours|
|• 37%||• 16-25%
• Iron containing products reduce cefdinir absorption by up to 80%
|• Excreted billiary,
mainly as unchanged drug in the feces. Urinary excretion is about 6%.
|• Cefdinir doesn't undergo significant metabolism.
• Cefdinir is eliminated predominantly via the kidneys.
|• Allergy to macrolide or ketolide antibiotics.
• History of hepatic dysfunction associated with prior use of azithromycin.
|• Allergy to the cephalosporin antibiotics.|
• Abdominal pain
• Abdominal pain, diarrhea,
• Cefdinir binds to iron in the gut, and may turn the stool read
Azithromycin vs Cefdinir for Otitis media
Both antibiotics are FDA-approved for the treatment of bacterial ear infection. Cefdinir is considered as a second line agent. The current pediatric guidelines do not recommend to use azithromycin to treat otitis media.
Cefdinir and azithromycin have comparable effectiveness in the treatment of acute otitis media1.
|Results of multicenter, prospective, investigator-blinded study of children (between the ages of 6 months and 6 years) with a clinical diagnosis of AOM 1||Azithromycin||Cefdinir|
|Regimen||10 mg/kg once daily on day 1 and 5 mg/kg once daily on days 2 through 5||7 mg/kg q12h for 5 days|
|Clinical cure rates||85% (149 patients of 176)||87% (151 patients of 174)|
|Clinical cure rates at the follow-up visit||86%||76%|
|Parents' satisfaction with regard to ease of use, taste, compliance, health care resource utilization, and missed days of work and day-care||
- Azithromycin (Zithromax) facts
- Azithromycin vs Amoxicillin
- Azithromycin vs Amoxicillin/Clavulanate
- Azithromycin vs Ciprofloxacin
- Azithromycin vs Clarithromycin
- Azithromycin vs Doxycycline
- Azithromycin vs Penicillin
- 1. Block SL, Cifaldi M, Gu Y, Paris MM. A comparison of 5 days of therapy with cefdinir or azithromycin in children with acute otitis media. Clin Ther. 2005 Jun;27(6):786-94. PubMed
Published: February 21, 2018
Last updated: February 21, 2018