Category:

• Antibiotic

Description:

• Cephalosporin, Third Generation

Indications:

• Lower respiratory tract infections (S. pneumoniae, S. aureus, E. coli, Klebsiella pneumoniae, H. influenzae H. parainfluenzae, Serratia marcescens, E. aerogenes, P. mirabilis)

• Urinary tract infections (E. coli, K. pneumoniae, P. vulgaris, Morganella morgani, P. miribalis)

• Intra-abdominal infections (E. coli, K. pneumoniae, B. fragilis, Clostridium species, Peptostreptococcus species)

• Skin, bone and joint infections (S. aureus, S. epidermidi S. pyogenes, viridans group streptococci, E. coli, Enterobacter cloacae, K. oxytoca, K. pneumoniae, P. miribalis, P. aeruginosa, Morganella morganii, S. marcescens, Actinetobacter calcoaceticus, B, fragilis, Peptostreptococcus species)

• Uncomplicated gonorrhea (N. gonorrhoeae)

• Pelvic inflammatory disease (N. gonorrhoeae)

• Bacterial septicemia (S. pneumoniae, S. aureus, E. coli, K. pneumoniae, H. influenzae)

• Meningitis (H. influenzae, N. meningitidis, S. pneumoniae)

Contraindications:

• Cross sensitivity with penicillin allergies

Precautions:

• Pregnancy category B

• Use with caution in patients with penicillin allergy (5-10% chance of cross-reactivity)

Adverse Reactions (Side Effects):

• Hypersensitivity reactions

• Gastrointestinal: nausea, vomiting, diarrhea

• Vaginitis

Dosage:

• Administered by injection (IM and IV)

• Adults:

  • 1-2 grams once a day (or divided into two equal does) [maximum daily 4 grams]

• uncomplicated gonococcal infections: 

  • 250mg single IM dose

• surgical prophylaxis: 

  • 1 gram IV dose 30 to 120 minutes pre-surgery

• Children:

  • 50-75mg/kg/day in two equally divided doses (maximum daily dose 2 grams)

• meningitis: 

  • 100mg/kg/day given once daily or divided into two doses(maximum daily dose 4 grams)

• Gonorrhea, chancroid, pelvic inflammatory disease:

• uncomplicated: 

  • 125mg IM as single dose plus 1 gram azithromycin single dose or 100mg doxycycline bid for 7 days

• conjunctivitis: 

  • 1 gram IM single dose

  • disseminated: 1 gram IM or IV every 24 hours

• Meningitis:

  • 1-2 grams IV every 12 hours for 10-14 days

• Endocarditis:

  • 1-2 grams IV every 12 hours for greater than 4 weeks

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