McKenna's Pharmacology for Nursing, 2e

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P A R T 2  Chemotherapeutic agents

TABLE 9.3

DRUGS IN FOCUS Cephalosporins

Drug name

Dosage/route

Usual indications

First-generation cephalosporins cefalotin (Keflin)

Adult: 500 mg–1 g IM or IV q 4–6 hours

Treatment of respiratory tract, skin, GU, biliary tract, bone and joint infections, as well as sepsis Treatment of respiratory tract, skin, GU, biliary tract, bone, joint and myocardial infections, as well as sepsis

cephazolin (Cefazolin)

Adult: 250–500 mg IM or IV q 4–8 hours; reduce dose in renal impairment Paediatric: 25–50 mg/kg/day IM or IV in three or four divided doses Adult: 250 mg PO q 6 hours Paediatric: 25–50 mg/kg/day PO in divided doses Adult: 250 mg PO q 8 hours—do not exceed 4 g/day; must be taken every 8–12 hours around the clock Paediatric: 20 mg/kg/day PO in divided doses q 8 hours; do not exceed 1 g/day Adult: 1–2 g IM or IV q 6–8 hours; reduce dose with renal impairment Paediatric: 30–40 mg IM or IV q 6 hours

cephalexin (Keflex, Cilex)

Treatment of respiratory, skin, bone, and GU infections; used for otitis media in children

Second-generation cephalosporins cefaclor (Ceclor, Keflor)

Treatment of respiratory tract infections, skin infections, UTIs, otitis media, typhoid fever, anthrax exposure

cefoxitin (generic)

Treatment of severe infections; preoperative prophylaxis for caesarean section and abdominal, vaginal, biliary or colorectal surgery; more effective in gynaecological and intra-abdominal infections than some other agents Treatment of a wide range of infections, as listed for other second-generation drugs; Lyme disease; preferred treatment in situations involving an anticipated switch from parenteral to oral drug use Treatment of moderate to severe skin, urinary tract and respiratory tract infections; pelvic inflammatory disease; intraabdominal infections; peritonitis; septicaemia; bone infections; CNS infections; preoperative prophylaxis Treatment of moderate to severe skin, urinary tract and respiratory tract infections; intraabdominal infections; septicaemia; bone infections; CNS infections Treatment of moderate to severe skin, urinary tract and respiratory tract infections; pelvic inflammatory disease; intraabdominal infections; peritonitis; septicaemia; bone infections; CNS infections; preoperative prophylaxis; off-label use for treatment of Lyme disease

cefuroxime (Zinnat)

Adult: 250–500 mg PO b.d. Paediatric: 125–250 mg PO b.d.; 50–100 mg/kg/day IM or IV in divided doses q 6–8 hours

Third-generation cephalosporins cefotaxime (generic)

Adult: 2–8 g/day IM or IV in divided doses q 6–8 hours; reduce dose with renal impairment Paediatric: 50–180 mg/kg/day IM or IV in divided doses q 4–6 hours Adult: 1 g q 8–12 hours IM or IV; reduce dose with renal impairment Paediatric: 25–100 mg/kg/day IV or IM t.d.s. or q.i.d. Adult: 1–2 g/day IM or IV in divided doses b.d.–q.i.d. Paediatric: 50–75 mg/kg/day IV or IM in divided doses q 12 hours

ceftazidime (Fortum)

ceftriaxone (Rocephin)

Fourth-generation cephalosporins cefepime (Maxipime)

Adult: 0.5–2 g IM or IV q 12 hours; must be injected for greatest effectiveness q 12 hours for 7–10 days; reduce dose with renal impairment Paediatric: 50 mg/kg per dose q 12 hours IV or IM for 7–10 days

Treatment of moderate to severe skin, urinary tract and respiratory tract infections

Fifth-generation cephalosporins ceftaroline (Zinforo)

Adult: 600 mg IV q 12 hours

Treatment of complicated skin and soft tissue infectioins or community-acquired pneumonia