Category:

• Antibiotic

Description:

• Cephalosporin, Third Generation

Indications:

• Lower respiratory tract infections (P. aeruginosa  and other Pseudomanas species, H. influenzae, Klebsiella species, S. pneumoniae, S. aureus, E. coli, Serratia species, Enterobacter species, P. mirabilis, Citrobacter species)

• Urinary tract infections (E. coli, Klebsiella species, Proteus species, Enterobacter species, P. aeruginosa)

• Skin, bone and joint infections (P. aeruginosa, Enterobacter species, E. coli, Proteus species, Klebsiella species, Serratia species, E. coli, S. aureus, S. pyogenes)

• Intra-abdominal infections (E. coli, Klebsiella species, S. aureus, Bacteroides species, polymicrobial infections caused by aerobic and anaerobic organisms)

• Bacterial septicemia (P. aeruginosa, Klebsiella species, H. influenzae, E. coli, Serratia species, S. pneumoniae, S. aureus)

• Gynecological infections (E. coli)

• CNS infections (H. influenzae, N. meningitidis)

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 injection (IM and IV)

• Adults:

  • 1 gram IV or IM every 8-12 hours

• uncomplicated urinary tract infections: 

  • 250mg IV or IM every 12 hours

• complicated urinary tract infections: 

  • 500mg IV or IM every 8-12 hours

• meningitis: 

  • 2 grams IV every 8 hours

• uncomplicated pneumonia, mild skin infections: 

  • 500mg – 1 gram IV or IM every 8 hours

• bone and joint infections: 

  • 2 grams IV every 12 hours

• meningitis: 

  • 2 grams IV every 8 hours

• severe, life-threatening infections: 

  • 2 grams IV every 8 hours

• pseudomonal lung infections: 

  • 30-50mg/kg IV every 8 hours (maximum 6 grams per day)

• Infants and Children (1 month – 1 year)

  • 30-50mg/kg IV every 8 hours (maximum 6 grams per day)

• Neonates (0-4 weeks):

  • 30mg/kg IV every 12 hours

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001