Category:

• Antibiotic

Description:

• Cephalosporin, Third Generation

Indications:

• Lower respiratory tract infections (Streptococcus species, H. influenzae, Klebsiella species, S. aureus, E. coli, Serratia species, Enterobacter species, P. mirabilis, Bacteroides species)

• Urinary tract infections (S. aureus, E. coli, Klebsiella species, P. mirabilis, P. vulgaris, Providencia rettgeri, Morganella morganii, Serratia species, Enterobacter species, Pseudomonas species)

• Gonorrhea (N. gonorrhoeae)

• Pelvic inflammatory disease (N. gonorrhoeae, E. coli, S. agalactiae)

• Intra-abdominal infections (E. coli, S. epidermidis, Streptococcus species, Enterobacter species, Klebsiella species, Bacteroides species, Peptococcus and Peptostreptococcus species)

• Septicemia (Streptococcus species, Klebsiella species, S. aureus, E. coli, Serratia species, Bacteroides species)

• Skin, bone and joint infections (S. aureus, S. epidermidis, E. coli, Klebsiella species, Streptococcus species, P. mirabilis, Serratia species, Enterobacter species, Bacteroides species (including Peptococcus and Peptostreptococcus species))

• Meningitis (H. influenzae)

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:

  • 1-2 grams IV or IM every 8-12 hours

• uncomplicated urinary tract infections: 

  • 500mg IV or IM every 12 hours

• PID: 

  • 2 grams IV every 8 hours

• other sites 

  • 1 gram Ivor IM every 8-12 hours

• severe or refractory infections: 

  • 1 gram IM or IV every 8 hours or 2 grams IM or IV every 8-12 hours

• life-threatening infections: 

  • 3-4 grams IV every 8 hours

• uncomplicated gonorrhea: 

  • 1 gram single IM injection

• Child (> 6 months)

  • 50-200mg/kg/day IV every 6-8 hours (maximum 6 grams per day)

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