Category:

• Antibiotic

Description:

• Cephalosporin, First Generation

Indications:

• Respiratory tract infections (S. pneumoniae, Klebsiella species, H. influenzae, S. aureus, group A beta-hemolytic streptococci)

• Genitourinary tract infections (E. coli, Klebsiella species, some Enterobacter species)

• Skin, bone, and joint infections (S. aureus, group A beta-hemolytic streptococci)

• Biliary tract infections (E. coli, Klebsiella species, Proteus mirabilis, S. aureus)

• Septicemia (S. pneumoniae, S. aureus, Klebsiella species, E. coli, Proteus mirabilis)

• Endocarditis (S. aureus, group A beta-hemolytic streptococci)

Contraindications:

• Cross sensitivity with penicillin allergies

Precautions:

• Pregnancy category B

• Use with caution in patients with penicillin allergy (5-10% chance of cross-reactivity)

• Dosage modifications are generally only required in patients with severe renal impairment

Adverse Reactions (Side Effects):

• Hypersensitivity reactions

• Gastrointestinal: nausea, vomiting, diarrhea

• Vaginitis  

Dosage:

• Administered by IV or IM injection

• Mild infections:

  • 250-500mg every 8 hours

• Moderate to severe infections:

  • 500mg -1 gram every 6-8 hours

• Pneumococcal pneumonia:

  • 500mg every 12 hours

• Severe, life-threatening infections:

  • 1-1.5 grams every 6 hours (up to 12 grams per day have been used)

• Acute, uncomplicated UTIs:

  • 1 gram every 12 hours

• Perioperative prophylaxis:

  • Pre-op: 1 gram IV or IM, ½ to 1 hour pre-surgery

• Intra-operative (>2 hours): 

  • 500mg – 1 gram IV or IM at appropriate intervals

• Post-op: 

  • 500mg – 1 gram IV or IM every 6-8 hours for 24 hours post surgery