Cefdinir for Recent-Onset Pediatric Neuropsychiatric Disorders: A Pilot Randomized Trial
Publication: Journal of Child and Adolescent Psychopharmacology
Volume 25, Issue Number 1
Abstract
Objective: Previous studies suggest that the unexplained sudden and severe onset of obsessive-compulsive disorder (OCD) and/or tics may be infection or immune precipitated. Beta lactam antibiotics may be neuroprotective beyond their antimicrobial efficacy. We examine the preliminary safety and efficacy of cefdinir in reducing obsessive-compulsive and/or tic severity in children with new-onset symptoms.
Method: Twenty subjects were randomized to receive placebo or cefdinir for 30 days for the treatment of recent-onset OCD and/or tics. The placebo group received a comparable inactive treatment matched for taste, color, and consistency. The Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) and Yale Global Tic Severity Scale (YGTSS) were the primary outcome measures utilized.
Results: Subjects receiving cefdinir saw notable improvements in tic symptoms, with 44.4% showing at least a 25% reduction in YGTSS (mean decrease=9.5) scores compared with 9.1% of the placebo group (mean decrease=0.13). Despite improvements, significant group differences were not observed for YGTSS (F [1, 13]=4.03, p=0.066) although there were moderate differences between group treatment effects (d=0.72). For OCD symptoms, subjects receiving cefdinir saw improvements in OCD symptoms, with 33.3% showing at least a 25% reduction in CY-BOCS scores (mean decrease=7.8) compared with 27.3% of the placebo group (mean decrease=4.7), but there were also no significant differences for CY-BOCS (F [1, 13]=0.385, p=0.546; d=0.24).
Conclusions: Subjects assigned to cefdinir exhibited notable, albeit nonstatistically significant, improvements in tic symptoms, compared with the placebo group. There were also some improvements in OCD symptoms, although these were not significant. Overall, cefdinir was well tolerated. Given these preliminary results, a fully powered study is warranted to explore the efficacy of cefdinir as a therapeutic tool for new-onset pediatric neuropsychiatric symptoms, particularly those that appear to be precipitated by infection.
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Information & Authors
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Published In

Journal of Child and Adolescent Psychopharmacology
Volume 25 • Issue Number 1 • February 2015
Pages: 57 - 64
PubMed: 25299463
Copyright
Copyright 2015, Mary Ann Liebert, Inc.
History
Published online: 19 February 2015
Published in print: February 2015
Published ahead of print: 9 October 2014
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Disclosures
Dr. Tanya Murphy has received research support in the past 3 years from All Children's Hospital Research Foundation, Centers for Disease Control, International OCD Foundation (IOCDF), National Institutes of Health, Ortho McNeil Scientific Affairs, Otsuka, Pfizer Pharmaceuticals, Roche Pharmaceuticals, Shire, Tourette Syndrome Association, and Transcept Pharmaceuticals, Inc. Dr. Murphy is on the Medical Advisory Board for Tourette Syndrome Association and on the Scientific Advisory Board for IOCDF. She receives a textbook honorarium from Lawrence Erlbaum. Dr. Ellisa C. Parker-Athill has no financial relationships to disclose. Dr. Eric Storch has received grant funding in the last 3 years from Agency for Healthcare Research and Quality, All Children's Hospital Research Foundation, Centers for Disease Control, IOCDF, National Alliance for Research on Schizophrenia and Affective Disorders, the National Institutes of Health, Ortho McNeil Scientific Affairs, and Tourette Syndrome Association. He receives a textbook honorarium from American Psychological Association, Lawrence Erlbaum, and Springer publishers. Dr. Storch has been an educational consultant for Rogers Memorial Hospital. He is a consultant for CroNos, Inc. and Prophase, Inc., and is on the Speaker's Bureau and Scientific Advisory Board for IOCDF. Dr. Adam Lewin receives grant funding from Agency for Healthcare Research and Quality, Centers for Disease Control, IOCDF, Joseph Drown Foundation, National Alliance for Research on Schizophrenia and Affective Disorders, National Institutes of Health, and University of South Florida Research Council. He is a consultant for Prophase, Inc., and has received speaker's honoraria from the Tourette Syndrome Association. He received travel reimbursement from Roche Pharmaceuticals. P. Jane Mutch, Ph.D. has no financial relationships to disclose.
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