Clinician's Pocket Drug Reference 2008

58 CefotaximeCefotaxime (Claforan) Uses: *Rx Infxns of resp tract, skin, bone, urinarytract, meningitis, sepsis* Action: 3rd-gen cephalosporin; ↓ cell wall synth.Spectrum: Most gram(–) (not Pseudomonas), some gram(+) cocci (not Enterococcus);many PCN-resistant pneumococci Dose: Adults. 1–2 g IV q4–12h. Peds.50–200 mg/kg/d IV ÷ q 4–12h; ↓ dose renal/hepatic impair Caution: [B, +] Arrhythmiaw/ rapid inj; w/colitis Contra: Cephalosporin allergy Disp: Powder forinj 500 mg, 1, 2, 10, 20 g, premixed infusions 20 mg/mL, 40 mg/mL SE: D, rash,pruritus, colitis, eosinophilia, ↑ transaminasesCefotetan (Cefotan) Uses: *Rx Infxns of the upper & lower resp tract,skin, bone, urinary tract, abdomen, & gynecologic system* Action: 2nd-gencephalosporin; ↓ cell wall synth Spectrum: Less active against gram(+); anaerobesincluding B. fragilis; gram(–), including E. coli, Klebsiella, & Proteus Dose:Adults. 1-3 g IV q12h. Peds. 20–40 mg/kg/divided IV ÷ q12h; ↓ w/renal impairCaution: [B, +] May ↑ bleeding risk; w/Hx of PCN allergies, w/other nephrotoxicdrugs Contra: Cephalosporin allergy Disp: Powder for inj 1, 2, 10 g SE: D, rash,eosinophilia, ↑ transaminases, hypoprothrombinemia, & bleeding (due to MTTside chain) Notes: May interfere w/ warfarinCefoxitin (Mefoxin) Uses: *Rx Infxns of the upper & lower resp tract,skin, bone, urinary tract, abdomen, & gynecologic system* Action: 2nd-gencephalosporin; ↓ cell wall synth. Spectrum: Good gram(–) against enteric bacilli(ie, E. coli, Klebsiella, & Proteus); anaerobic B. fragilis Dose: Adults. 1–2 g IVq6–8h. Peds. 80–160 mg/kg/d ÷ q4–6h; ↓ in renal impair Caution: [B, +] Contra:Cephalosporin allergy Disp: Powder for inj 1, 2, 10 g SE: D, rash, eosinophilia, ↑transaminasesCefpodoxime (Vantin) Uses: *Rx resp, skin, & urinary tract Infxns* Action:3rd-gen cephalosporin; ↓ cell wall synth. Spectrum: S. pneumoniae or nonβ-lactamase-producingH. influenzae; acute uncomplicated N. gonorrhoeae; someuncomplicated gram(–) (E. coli, Klebsiella, Proteus) Dose: Adults. 100–400 mgPO q12h. Peds. 10 mg/kg/d PO ÷ bid; ↓ in renal impair, w/ food Caution: [B, +]Contra: Cephalosporin allergy Disp: Tabs 100, 200 mg; susp 50, 100 mg/5 mLSE: D, rash, HA, eosinophilia, ↑ transaminases Notes: Drug interactions w/ agentsthat ↑ gastric pHCefprozil (Cefzil) Uses: *Rx resp tract, skin, & urinary tract Infxns* Action:2nd-gen cephalosporin; ↓ cell wall synth. Spectrum: Active against MSSA,strep, & gram(–) bacilli (E. coli, Klebsiella, P. mirabilis, H. influenzae, Moraxella)Dose: Adults. 250–500 mg PO daily-bid. Peds. 7.5–15 mg/kg/d PO ÷ bid; ↓ inrenal impair Caution: [B, +] Contra: Cephalosporin allergy Disp: Tabs 250, 500mg; susp 125, 250 mg/5 mL SE: D, dizziness, rash, eosinophilia, ↑ transaminasesNotes: Use higher doses for otitis & pneumoniaCeftazidime (Fortaz, Tazicef) Uses: *Rx resp tract, skin, bone, urinarytract Infxns, meningitis, & septicemia* Action: 3rd-gen cephalosporin; ↓ cell wallsynth. Spectrum: P. aeruginosa sp, good gram(–) activity Dose: Adults. 500–2 g