Staphylococcus aureus (methicillin susceptible), Coagulase negative Staphylococci, Streptococcus pneumoniae (penicillin susceptible), Streptococcus spp., Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitides, Neisseria gonorrhoeae, Enterobacteriaceae, E. coli
Cephalosporins exert bactericidal activity by interfering with bacterial cell wall synthesis and inhibiting cross-linking of the peptidoglycan. The cephalosporins are also thought to play a role in the activation of bacterical cell autolysins which may contribute to bacterial cell lysis.
Cephalosporins exhibit time-dependent killing (T > MIC)
Dose of 1g: Cmax: 84 mcg/L; Half-life: 1.8 hours; Volume of distribution: 28L; Table 11
Hypersensitivity: Maculopapular rash, Urticaria, Pruritis, Anaphylaxis/angioedema, eosinophilia
Hematologic: Hypoprothrombinemia, Neutropenia, Leukopenia, Thrombocytopenia
GI: Diarrhea, C. difficile disease
Renal: Interstitial nephritis
IV: Powder for reconstitution: 500mg, 1g, 2g, 10g, 20g
Intravenous Solution: 1g/50mL, 2 g/50mL
Gonorrhea: 1 g IM x 1 dose
Skin and/or subcutaneous tissue infection: 1 g IV/IM q8-12h
Intra-abdominal infection: 1 g IV/IM q8-12h
Meningitis: 1 g IV/IM q8h or 2g IV/IM q8-12h
UTI: 1-2 g IV/IM q8-12h
100-200mg/kg/day divided q6-8h
Renal failure: CrCl > 80mL/min: standard dosing
CrCl 50-80mL/min: 0.75g-1.5g q8h
CrCl 5-49mL/min: 0.5g-1g q12h
CrCl < 5mL/min: 0.5g q24h OR 1q q48h
Hepatic failure: No dosing changes recommended at this time.
Precautions: hypersensitivity to penicillins, history of gastrointestinal disease, particularly colitis,
Live Typhoid Vaccine: decreased immunological response to the typhoid vaccine
Category B: No evidence of risk in humans but studies inadequate.
Therapeutic: Culture and sensitivities, serum levels, signs and symptoms of infection, white blood cell count
Toxic: Urinalysis, BUN, SCr, AST and ALT, skin rash, Neutropenia and leukopenia, Prothrombin time in patients with renal or hepatic impairment or poor nutritional state, as well as patients receiving a protracted course of antimicrobial therapy, and patients previously stabilized on anticoagulant therapy.