Abstract
Background
Cefdinir is an extended-spectrum, third-generation, oral cephalosporin widely used
in pediatric population to treat common bacterial infections, including otitis media
and streptococcal pharyngitis. It is considered a safe and well-tolerated alternative
to penicillin and macrolides.
Case Report
This report describes a case series of 3 infants presenting to the emergency department
for evaluation of “bloody diarrhea.” The parents noticed red stools when their children
were started on oral cefdinir when they were previously receiving iron-containing
preparations. Reddish-colored heme-negative stools observed in all cases were due
to the interaction of the drug with supplemental iron or iron-containing formula feeds.
This adverse effect was reversible on discontinuation of cefdinir. Why Should an Emergency
Physician Be Aware of This? Red stools due to cefdinir is an underreported benign
adverse drug reaction with fewer than 10 cases described in the literature. Thorough
history taking with an appropriate focus on diet and drug history are essential to
avoid parental anxiety, unnecessary patient workup, and economic burden to the caregivers
in these cases. Awareness of this unusual adverse effect among emergency physicians
could prevent further inconvenience for already overburdened health systems.
Keywords
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Article info
Publication history
Published online: December 23, 2022
Accepted:
December 13,
2022
Received in revised form:
November 8,
2022
Received:
September 14,
2022
Publication stage
In Press Uncorrected ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
