Clinician's Pocket Drug Reference 2008

Cefoperazone 57lergy Disp: Inj: 500 mg, 1, 10, 20 g SE: D, rash, eosinophilia, ↑ LFT, inj site painNotes: Widely used for surgical prophylaxisCefdinir (Omnicef) Uses: *Infxns of the resp tract, skin, bone, & urinarytract* Action: 3rd-gen cephalosporin; ↓ cell wall synth Spectrum: Manygram(+)&(–) organisms; more active than cefaclor & cephalexin against Streptococcus,Staphylococcus; some anaerobes Dose: Adults. 300 mg PO bid or 600mg/d PO. Peds. 7 mg/kg PO bid or 14 mg/kg/d PO; ↓ in renal impair Caution: [B,+] w/PCN-sensitive pts, serum sicknesslike Rxns reported Contra: Hypersensitivityto cephalosporins Disp: Caps 300 mg; susp 125, 250 mg/5 mL SE: Anaphylaxis,D, rare pseudomembranous colitisCefditoren (Spectracef) Uses: *Acute exacerbations of chronic bronchitis,pharyngitis, tonsillitis; skin Infxns* Action: 3rd-gen cephalosporin; ↓ cell wallsynth. Spectrum: Good gram (+) (Strep & Staph); gram (–) (Haemophilus influenzae& Moraxella catarrhalis) Dose: Adults & Peds >12 y. Skin: 200 mg PO bid ×10 days. Chronic bronchitis, pharyngitis, tonsillitis: 400 mg PO bid × 10 days;avoid antacids w/in 2 h; take w/ meals; ↓ in renal impair Caution: [B, ?] Renal/hepaticimpair Contra: Cephalosporin/PCN allergy, milk protein, or carnitine deficiencyDisp: 200 mg tabs SE: HA, N/V/D, colitis, nephrotox, hepatic dysfunction,Stevens-Johnson synd, toxic epidermal necrolysis, allergic Rxns Notes: Causesrenal excretion of carnitine; tablets contain milk proteinCefepime (Maxipime) Uses: *UTI, pneumonia, febrile neutropenia,skin/soft tissue Infxns* Action: 4th-gen cephalosporin; ↓ cell wall synth. Spectrum:gram(+) S. pneumoniae, S. aureus, gram(–) K. pneumoniae, E. coli, P. aeruginosa,& Enterobacter sp Dose: Adults. 1–2 g IV q6-12h. Peds. 50 mg/kg q8h forfebrile neutropenia; 50 mg/kg bid for skin/soft tissue Infxns; ↓ in renal impairCaution: [B, +] Contra: Cephalosporin allergy Disp: Inj 500 mg, 1, 2 g SE: Rash,pruritus, N/V/D, fever, HA, (+) Coombs’ test w/o hemolysis Notes: give IM or IVCefixime (Suprax) Uses: *Infxns of the resp tract, skin, bone, & urinarytract* Action: 3rd-gen cephalosporin; ↓ cell wall synth. Spectrum: S. pneumoniae,S. pyogenes, H. influenzae, & enterobacteria. Dose: Adults. 400 mg PO daily-bid.Peds. 8–20 mg/kg/d PO ÷ daily-bid; ↓ in renal impair Caution: [B, +] Contra:Cephalosporin allergy Disp: Susp 100 mg/5 mL, 200 mg/5mL SE: N/V/D, flatulence,& abd pain Notes: Monitor renal & hepatic Fxn; use susp for otitis mediaCefoperazone (Cefobid) Uses: *Rx Infxns of the resp, skin, urinarytract, sepsis* Action: 3rd-gen cephalosporin; ↓ bacterial cell wall synth. Spectrum:gram(–) (eg, E. coli, Klebsiella), P. aeruginosa but < ceftazidime; gram (+) variableagainst Streptococcus & Staphylococcus sp Dose: Adults. 2–4 g/d IM/IV ÷ q8–12h (12 g/d max). Peds. (not approved) 100–150 mg/kg/d IM/IV ÷ bid-tid (12g/d max); ↓ in renal/hepatic impair Caution: [B, +] May ↑ bleeding risk Contra:Cephalosporin allergy Disp: Powder for inj 1, 2, 10 g SE: D, rash, eosinophilia, ↑LFTs, hypoprothrombinemia, & bleeding (due to MTT side chain) Notes: May interferew/ warfarin