Category:

• Antibiotic

Description:

• Cephalosporin, First Generation

Indications:

• Respiratory tract infections (S. pneumoniae, group A beta-hemolytic streptococci)

• Otitis media (S. pneumoniae, H. influenzae, staphylococci, group A beta-hemolytic streptococci)

• Urinary tract infections (E. coli, Klebsiella species, P. mirabilis)

• Skin, bone, and joint infections (staphylococci, 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)

• Counsel patient to finish all medication to prevent development of resistance

Adverse Reactions (Side Effects):

• Hypersensitivity reactions

• Gastrointestinal: nausea, vomiting, diarrhea

• Vaginitis  

Dosage:

• Administered orally (capsules and oral suspension) and by IM or IV injection

• Adults:

  • Skin, Resp Tract infections: 250mg every 6 hours or 500mg every 12 hours

  • Lobar pneumonia: 500mg every 6 hours or 1 gram every 12 hours

  • Uncomplicated UTI: 500mg every 12 hours

  • Serious infections and prostatitis: 500mg every 6 hours or 1 gram every 12 hours

• Children > 9 months old:

  • 25-50mg/kg/day in divided doses every 6 or 12 hours

  • Otitis media form H. influenzae: 75-100mg/kg/day every 6 or 12 hours (not to exceed 4 grams a day)

• Parenteral:

  • Adults: 2-4 grams in equally divided does 4 times a day

  • Bone infections: 1 gram IV four times a day

  • Cesarean section: 1 gram IV immediately after umbilical cord is clamped, give 2d and 3^rd doses as 1 gram IM or IV at 6-12 hours after first dose

• Perioperative prophylaxis:

  • Pre-op: 1 gram IV or IM, 30 to 90 minutes pre-surgery

  • Intra- and Post-operative (>2 hours): 1 gram IV or IM every 4 to 6 hours for 1 or 2 dose