Category:

• Antibiotic

Description:

• Cephalosporin, Second Generation

Indications:

• Lower respiratory tract infections (S. pneumoniae, S. aureus, H. influenzae, Klebsiella species, P. mirabilis, E. coli, Serratia marcescens)

• Urinary tract infections (E. coli, Klebsiella species, Proteus species (including P. vulgaris, Providencia rettgeri, Morganella morganii))

• Gynecological infections (S. aureus, S. epidermidis, Streptococcus species, S. agalactiae, E. coli, P. mirabilis, N. gonorrhoeae, Bacteriodes  species (including  B. distasonis, B. ovatus, B. thetaiotaomicron), Fusobacterium  species, gram-positive anaerobic cocci (including Peptococcus and Peptostreptococcus species))

• Intra-abdominal infections (E. coli, Klebsiella species, Streptococcus species, Bacteriodes  species (including  B. distasonis, B. ovatus, B. thetaiotaomicron), Clostridium species)

• Skin, bone and joint infections (E. coli, S. aureus, S. epidermidis, S. pyogenes, Streptococcus species, Klebsiella pneumonia, Peptococcus niger, Peptostreptococcus species)

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 IM or IV injection

• Adults:

  • 1-2 grams every 12 hours IM or IV for 5-10 days

• Urinary Tract Infections:

  • 1-4 grams per day (500mg q12h, 1-2 grams q12h, or 1-2 grams q24h given IV or IM)

• Skin infections:

  • mild to moderate: 2 grams per day (2 grams q24h IV or 1 gram q12h IV or IM)

  • severe: 4 grams per day (2 grams q12h IV)

• Severe to life-threatening infections:

  • 4-6 grams per day (2-3 grams q12h IV)

• Perioperative prophylaxis:

  • Pre-op: 1-2 grams IV or IM, 30 to 60 minutes pre-surgery