Category:

• Antibiotic

Description:

• Cephalosporin, Second Generation

Indications:

• Lower respiratory tract infections (S. pneumoniae, other streptococcus species, S. aureus, E. coli, Klebsiella species, H. influenzae, Bacteriodes  species)

• Urinary tract infections (E. coli, Klebsiella species, indole-positive Proteus species (including P. vulgaris, Morganella morgani ), P. miribalis, Providencia rettgeri, N. gonorrhoeae)

• Gynecological infections (E. coli, N. gonorrhoeae, Bacteriodes  species, Clostridium species, Peptococcus and Peptostreptococcus species and group B streptococci)

• Intra-abdominal infections (E. coli, Klebsiella species, Bacteriodes  species, Clostridium species)

• Skin, bone and joint infections (S. aureus, S. epidermidis, streptococcus species, E. coli, P. miribalis, Klebsiella species, Bacteriodes  species, Clostridium species, Peptococcus and Peptostreptococcus species)

• Septicemia (S. pneumoniae, S. aureus, E. coli, Klebsiella species, Bacteriodes  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 6-8 hours IM or IV for 5-10 days

• Child:

  • 80-160mg/kg/day in divided does every 4-6 hours

• Uncomplicated infections:

  • 3-4 grams per day (1 gram q6-8h IV)

• Moderate to severe infections:

  • 6-8 grams per day (1 gram q4h IV or 2 grams q6-8h IV)

• Infections generally requiring high dosages (gas gangrene):

  • 12 grams per day (2 grams q4h IV or 3 grams q6h IV)

• Uncomplicated gonorrhea: 

  • 2g IM with 1 gram oral probenecid given concurrently

• Perioperative prophylaxis:

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

  • Post-op: 2 grams q6h IV for less than 24 hours

• Cesarean section prophylaxis:

  • 2 gram IN as soon as umbilical cord is clamped

  • if three dose regimen: 2d and 3^rd doses of 2 grams IV given 4 & 8 hours after first dose

• Transurethral prostatectomy prophylaxis:

  • 1 gram IV pre-op and 1 gram q8h IV for less than 5 days

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