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==General==
==General==
*Type:  
*Type: [[Is Generation::2nd generation]]  [[Is DrugClass::cephalosporin]]
*Dosage Forms:
*Dosage Forms: injectable solution, powder for injection
*Common Trade Names:  
*Dosage Strengths: injectable solution: 20mg/mL, 40mg/mL; powder for injection: 1g, 2g, 10g
*Routes of Administration: IV, IM
*Common Trade Names: Cefotan


==Adult Dosing==
==Adult Dosing==
===[[Infection]]===
*Mild to Moderate, Bacterial
**1-2 g IM/IV q12h
***Max: 4 g/day
*Severe to Life Threatening, Bacterial
**2-3 g IV q 12h
***Max: 6 g/day
===[[UTI]], uncomplicated===
*500 mg IM/IV q12h
===[[PID]], severe===
*2 g IV q12h with [[doxycycline]]
===Prophylaxis===
*Surgical:
**2 g IV x1
*Postcesarean:
**2 g IV x1


==Pediatric Dosing==
==Pediatric Dosing==
===[[Infection]], bacterial===
*40-80 mg/kg/day IM/IV divided q12h
**Max: 4 g/day or 6 g/day in life-threatening infection
===[[PID]], severe===
*Adolescents
**2g IV q12h with [[doxycycline]]
===Prophylaxis===
*Surgical, >1yo
**40 mg/kg IV x1


==Special Populations==
==Special Populations==
*Pregnancy:
*Pregnancy: B
*Lactation:
*Lactation: May use while breastfeeding
*Renal Dosing
*Renal Dosing
**Adult
**Adult
***CrCl 10-30: Give q 24h
***CrCl <10: Give q 48h
***HD: Decrease usual dose 50% on dialysis days and 75% non-dialysis days
***PD: 1 g q24h
**Pediatric
**Pediatric
***CrCl 10-30: Give q 24h
***CrCl <10: Give q 48h
***HD: Decrease usual dose 50% on dialysis days and 75% non-dialysis days
***PD: No supplement
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult
***Not defined
**Pediatric
**Pediatric
***Not defined


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
*[[Hemolytic anemia]], cephalosporin-associated
*Caution:
**Hypersensitivity to [[penicillin]]
**Elderly
**Concurrent nephrotoxic agent
**Renal impairment
**Hepatic impairment
**[[Seizure]] disorder
**Malignancy
**Malnutrition
**GI disorder hx
**Recent abx-associated C. diff colitis


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Hypersensitivity reaction
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]], toxic epidermal necrolysis
*Erythema multiforme
*[[Hemolytic anemia]], [[Aplastic anemia]]
*[[Agranulocytosis]], [[Pancytopenia]], [[Neutropenia]], [[Thrombocytopenia]]
*Superinfection
*C. diff associated [[diarrhea]]
*[[Seizures]]
*Hepatic impairment, nephrotoxicity


===Common===
===Common===
*[[Diarrhea]], [[Nausea]]
*[[Pruritus]], [[Rash]], [[Phlebitis]], [[Urticaria]]
*Increased LFTs


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 3-4.6h (10h with moderate renal impairment)
*Metabolism:  
*Metabolism: Minimal
*Excretion:  
*Excretion: Urine primarily (51-81% unchanged)
*Mechanism of Action:
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||'''S'''
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||X1
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||I
|-
| ||[[N. meningitidis]]||I
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||I
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||'''S'''
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||X1
|-
| ||[[Shigella]] sp||X1
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||'''S'''
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||I
|-
| ||[[Citrobacter sp.]]||I
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||I
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||X1
|-
| ||[[Mycoplasm pneumoniae]]||X1
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||I
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
<references/>


<references/>
[[Category:Pharmacology]] [[Category:ID]]
[[Category:Drugs]]

Revisión actual - 16:10 18 jul 2025

General

  • Type: 2nd generation cephalosporin
  • Dosage Forms: injectable solution, powder for injection
  • Dosage Strengths: injectable solution: 20mg/mL, 40mg/mL; powder for injection: 1g, 2g, 10g
  • Routes of Administration: IV, IM
  • Common Trade Names: Cefotan

Adult Dosing

Infection

  • Mild to Moderate, Bacterial
    • 1-2 g IM/IV q12h
      • Max: 4 g/day
  • Severe to Life Threatening, Bacterial
    • 2-3 g IV q 12h
      • Max: 6 g/day

UTI, uncomplicated

  • 500 mg IM/IV q12h

PID, severe

Prophylaxis

  • Surgical:
    • 2 g IV x1
  • Postcesarean:
    • 2 g IV x1

Pediatric Dosing

Infection, bacterial

  • 40-80 mg/kg/day IM/IV divided q12h
    • Max: 4 g/day or 6 g/day in life-threatening infection

PID, severe

Prophylaxis

  • Surgical, >1yo
    • 40 mg/kg IV x1

Special Populations

  • Pregnancy: B
  • Lactation: May use while breastfeeding
  • Renal Dosing
    • Adult
      • CrCl 10-30: Give q 24h
      • CrCl <10: Give q 48h
      • HD: Decrease usual dose 50% on dialysis days and 75% non-dialysis days
      • PD: 1 g q24h
    • Pediatric
      • CrCl 10-30: Give q 24h
      • CrCl <10: Give q 48h
      • HD: Decrease usual dose 50% on dialysis days and 75% non-dialysis days
      • PD: No supplement
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

Contraindications

  • Allergy to class/drug
  • Hemolytic anemia, cephalosporin-associated
  • Caution:
    • Hypersensitivity to penicillin
    • Elderly
    • Concurrent nephrotoxic agent
    • Renal impairment
    • Hepatic impairment
    • Seizure disorder
    • Malignancy
    • Malnutrition
    • GI disorder hx
    • Recent abx-associated C. diff colitis


Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 3-4.6h (10h with moderate renal impairment)
  • Metabolism: Minimal
  • Excretion: Urine primarily (51-81% unchanged)
  • Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium X1
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae I
N. meningitidis I
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg I
Enterobacter sp, AmpC pos R
Serratia sp S
Serratia marcescens X1
Salmonella sp X1
Shigella sp X1
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii R
Citrobacter diversus I
Citrobacter sp. I
Aeromonas sp S
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica I
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida S
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp X1
Mycoplasm pneumoniae X1
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis I
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
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