100
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
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
Treatment of respiratory tract, skin, GU, biliary
tract, bone, joint and myocardial infections, as
well as sepsis
cephalexin (Keflex,
Cilex)
Adult: 250 mg PO q 6 hours
Paediatric: 25–50 mg/kg/day PO in divided
doses
Treatment of respiratory, skin, bone, and GU
infections; used for otitis media in children
Second-generation cephalosporins
cefaclor (Ceclor,
Keflor)
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
Treatment of respiratory tract infections, skin
infections, UTIs, otitis media, typhoid fever,
anthrax exposure
cefoxitin (generic)
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
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
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
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
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
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
ceftazidime (Fortum)
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.
Treatment of moderate to severe skin,
urinary tract and respiratory tract infections;
intraabdominal infections; septicaemia; bone
infections; CNS infections
ceftriaxone (Rocephin)
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
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
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
