Diferencia entre revisiones de «Oxacephem»

(Created page with " This is an example wiki page for the This is an emergency medicine antibiotic wiki example page that is on the wiki wikem.org ==General== *Type: Is Generation::1st generation Is DrugClass::Cephalosporin *Dosage Forms: powder for injection *Dosage Strengths: 500mg; 1, 2, 10, 20, 100, 300g *Routes of Administration: IV, IM *Common Trade Names: Ancef ==Adult Dosing== ===General=== *Mild: 250-500mg IM/IV 8h *Mod-Severe: 500-1000mg IM/IV q6-8h *Life Threatening:...")
 
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This is an example wiki page for the
This is an emergency medicine antibiotic wiki example page that is on the wiki wikem.org
==General==
==General==
*Type: [[Is Generation::1st generation]] [[Is DrugClass::Cephalosporin]]
*Type: [[Is Generation::Oxacephem]] [[Is DrugClass::Beta-lactam]]
*Dosage Forms: powder for injection
*Dosage Forms: powder for injection
*Dosage Strengths: 500mg; 1, 2, 10, 20, 100, 300g
*Dosage Strengths: 1g
*Routes of Administration: IV, IM
*Routes of Administration: IV, IM
*Common Trade Names: Ancef
*Common Trade Names: Flomox (Flomoxef), Latamoxef (Moxalactam - withdrawn in many regions)


==Adult Dosing==
==Adult Dosing==
===General===
===General===
*Mild: 250-500mg IM/IV 8h
*Standard: 1-2g IM/IV daily divided q8-12h
*Mod-Severe: 500-1000mg IM/IV q6-8h
*Severe: Up to 4g/day divided q6-8h
*Life Threatening: 1-1.5g IM/IV q6h
*Max: 4g/day
*Max: 12g/day


===[[UTI]], Uncomplicated===
===[[UTI]], Complicated===
*1g IM/IV q12
*1g IM/IV q12h


===Pneumococcal [[Pneumonia]]===
===Intra-abdominal Infections===
*500mg IM/IV q12
*1-2g IM/IV q8-12h
*Notable for excellent anaerobic coverage (similar to cefoxitin/metronidazole)


===[[Endocarditis]] Prophylaxis, Dental===
===Respiratory Tract Infections===
*1g IM/IV x1 (30-60 min before procedure)
*1-2g IM/IV divided q8-12h


==Pediatric Dosing==
==Pediatric Dosing==
===General (<7 Days)===
===General===
*40mg/kg/day IM/IV divided q12h
*60-80 mg/kg/day IM/IV divided q6-8h
*First Dose: 20mg/kg IM/IV x 1
*Severe: Up to 150 mg/kg/day IM/IV divided q6-8h
*Max 6g/day
 
===General (>7 Days - 1 Month)===
*<2000g
**40mg/kg/day IM/IV divided q12h
**First Dose: 20mg/kg IM/IV x 1
**Max 6g/day
*>2000g
**60mg/kg/day IM/IV divided q8h
**First Dose: 20mg/kg IM/IV x 1
**Max 6g/day
 
===General (>1 Month)===
*25-100mg/kg/day IM/IV divided q6-8h
*First Dose: 20-33mg/kg IM/IV x 1
*Max 6g/day
 
===Community Acquired [[Pneumonia]] (>3 Months)===
*150mg/kg/day IM/IV divided q8h x 10 days
*First Dose: 50mg/kg IM/IV x 1
*May switch to PO regimen when able


==Special Populations==
==Special Populations==
*Pregnancy: B
*Pregnancy: B
*Lactation: Safe
*Lactation: Excreted in breast milk; use with caution
*Renal
*Renal
**Adult
**Adult (Flomoxef)
***CrCl 35-54: give q8
***CrCl 50-70: No adjustment usually required
***CrCl 11-34: give usual dose x1, then decrease dose 50% and give q12h
***CrCl 20-49: 1g q12h
***CrCl <10: give usual dose x1, then decrease dose 50% and give q18-24h
***CrCl 10-19: 1g q24h
***Hemodialysis: give 0.5-1g supplement
***CrCl <10: 500mg-1g q24h
***Peritoneal dialysis: 500mg q12h
***Hemodialysis: Administer dose after dialysis
**Pediatric
**Pediatric
***CrCl 40-70: give usual dose x 1, then decrease daily dose 40% and give q12h
***Renal impairment requires interval extension based on GFR
***CrCl 20-39: give usual dose x 1, then decrease daily dose 75% and give q12h
*Hepatic
***CrCl 5-19: give usual dose x 1, the decerase daily dose 90% and give q24h
**No adjustment defined
***CrCl <5: not defined
***Hemodialysis: give supplement
***Peritoneal dialysis: no supplement
*Hepatic (Adult & Pediatric)
**Not defined


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug (Oxacephems or Cephalosporins)
*History of anaphylactic shock


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Neutropenia
*[[Thrombocytopenia]]
*[[Anaphylaxis]]
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*[[Stevens-Johnson Syndrome]]
*Nephrotoxicity
*[[Seizures]]
*[[Clostridium difficile]]
*[[Clostridium difficile]]
*Bleeding Diathesis (Associated historically with Latamoxef/Moxalactam due to MTT side chain; less common with Flomoxef)
*[[Seizures]] (in high doses/renal failure)


===Common===
===Common===
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*[[Nausea and Vomiting]]
*[[Nausea and Vomiting]]
*[[Abdominal Pain]]
*[[Abdominal Pain]]
*Anorexia
*Transaminitis
*Transaminitis
*Urticaria
*Eosinophilia
*Thrombophlebitis


==Pharmacology==
==Pharmacology==
*Half-life: 1.8h (3.7 ESRD)
*Half-life: ~50 minutes (Flomoxef)
*Metabolism: minimally metabolized in liver; CYP450
*Metabolism: Minimally metabolized
*Excretion: Urine
*Excretion: Urine
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis.
*Structure Note: The sulfur atom in the dihydrothiazine ring of the cephalosporin nucleus is replaced by an oxygen atom. This substitution generally confers increased stability against beta-lactamases.


==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
==[[Antibiotic Sensitivities]]<ref>Sanford Guide / Japanese Journal of Antibiotics</ref>==
{| class="wikitable"
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Group'''
Línea 118: Línea 85:
| ||[[Enterococcus faecalis]]||R
| ||[[Enterococcus faecalis]]||R
|-
|-
| ||[[Enterococcus faecium]]||X1
| ||[[Enterococcus faecium]]||R
|-
|-
| ||[[MSSA]]||'''S'''
| ||[[MSSA]]||'''S'''
Línea 134: Línea 101:
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
|-
| ||[[N. meningitidis]]||R
| ||[[N. meningitidis]]||'''S'''
|-
|-
| ||[[Moraxella catarrhalis]]||I
| ||[[Moraxella catarrhalis]]||'''S'''
|-
|-
| ||[[H. influenzae]]||'''S'''
| ||[[H. influenzae]]||'''S'''
Línea 148: Línea 115:
| ||E coli/Klebsiella KPC+||R
| ||E coli/Klebsiella KPC+||R
|-
|-
| ||[[Enterobacter]] sp, AmpC neg||R
| ||[[Enterobacter]] sp, AmpC neg||I
|-
|-
| ||[[Enterobacter]] sp, AmpC pos||R
| ||[[Enterobacter]] sp, AmpC pos||R
|-
|-
| ||[[Serratia]] sp||R
| ||[[Serratia]] sp||I
|-
|-
| ||Serratia marcescens||X1
| ||Serratia marcescens||I
|-
|-
| ||[[Salmonella]] sp||X1
| ||[[Salmonella]] sp||'''S'''
|-
|-
| ||[[Shigella]] sp||X1
| ||[[Shigella]] sp||'''S'''
|-
|-
| ||[[Proteus mirabilis]]||'''S'''
| ||[[Proteus mirabilis]]||'''S'''
|-
|-
| ||[[Proteus vulgaris]]||R
| ||[[Proteus vulgaris]]||'''S'''
|-
|-
| ||[[Providencia sp.]]||R
| ||[[Providencia sp.]]||'''S'''
|-
|-
| ||[[Morganella sp.]]||R
| ||[[Morganella sp.]]||'''S'''
|-
|-
| ||[[Citrobacter freundii]]||R
| ||[[Citrobacter freundii]]||I
|-
|-
| ||[[Citrobacter diversus]]||R
| ||[[Citrobacter diversus]]||'''S'''
|-
|-
| ||[[Citrobacter sp.]]||R
| ||[[Citrobacter sp.]]||I
|-
|-
| ||[[Aeromonas sp]]||R
| ||[[Aeromonas sp]]||'''S'''
|-
|-
| ||[[Acinetobacter sp.]]||R
| ||[[Acinetobacter sp.]]||R
Línea 184: Línea 151:
| ||[[Stenotrophomonas maltophilia]]||R
| ||[[Stenotrophomonas maltophilia]]||R
|-
|-
| ||[[Yersinia enterocolitica]]||R
| ||[[Yersinia enterocolitica]]||'''S'''
|-
|-
| ||[[Francisella tularensis]]||X1
| ||[[Francisella tularensis]]||X1
Línea 198: Línea 165:
| ||[[Vibrio vulnificus]]||X1
| ||[[Vibrio vulnificus]]||X1
|-
|-
| Misc||[[Chlamydophila sp]]||X1
| Misc||[[Chlamydophila sp]]||R
|-
|-
| ||[[Mycoplasm pneumoniae]]||X1
| ||[[Mycoplasm pneumoniae]]||R
|-
|-
| ||[[Rickettsia sp]]||X1
| ||[[Rickettsia sp]]||R
|-
|-
| ||[[Mycobacterium avium]]||X1
| ||[[Mycobacterium avium]]||R
|-
|-
| Anaerobes||[[Actinomyces]]||X1
| Anaerobes||[[Actinomyces]]||X1
|-
|-
| ||[[Bacteroides fragilis]]||R
| ||[[Bacteroides fragilis]]||'''S'''
|-
|-
| ||[[Prevotella melaninogenica]]||X1
| ||[[Prevotella melaninogenica]]||'''S'''
|-
|-
| ||[[Clostridium difficile]]||X1
| ||[[Clostridium difficile]]||X1
|-
|-
| ||[[Clostridium (not difficile)]]||X1
| ||[[Clostridium (not difficile)]]||'''S'''
|-
|-
| ||[[Fusobacterium necrophorum]]||X1
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
|-
| ||[[Peptostreptococcus sp.]]||X1
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
|}


Línea 229: Línea 196:
==References==
==References==
<references/>
<references/>
*Epocrates


[[Category:Pharmacology]] [[Category:ID]]
[[Category:Pharmacology]] [[Category:ID]]
please create a new wiki page formatted in the same way as the wikitext in the example but for this antibiotic  Oxacephem and don't forget to put the [[Category:Pharmacology]] [[Category:ID]] at the end.  Make sure you use the semantic mediawiki text for the cephalosporin type such as *Type: [[Is Generation::1st generation]] [[Is DrugClass::Cephalosporin]] if it applies

Revisión actual - 20:06 28 ene 2026

General

  • Type: Oxacephem Beta-lactam
  • Dosage Forms: powder for injection
  • Dosage Strengths: 1g
  • Routes of Administration: IV, IM
  • Common Trade Names: Flomox (Flomoxef), Latamoxef (Moxalactam - withdrawn in many regions)

Adult Dosing

General

  • Standard: 1-2g IM/IV daily divided q8-12h
  • Severe: Up to 4g/day divided q6-8h
  • Max: 4g/day

UTI, Complicated

  • 1g IM/IV q12h

Intra-abdominal Infections

  • 1-2g IM/IV q8-12h
  • Notable for excellent anaerobic coverage (similar to cefoxitin/metronidazole)

Respiratory Tract Infections

  • 1-2g IM/IV divided q8-12h

Pediatric Dosing

General

  • 60-80 mg/kg/day IM/IV divided q6-8h
  • Severe: Up to 150 mg/kg/day IM/IV divided q6-8h

Special Populations

  • Pregnancy: B
  • Lactation: Excreted in breast milk; use with caution
  • Renal
    • Adult (Flomoxef)
      • CrCl 50-70: No adjustment usually required
      • CrCl 20-49: 1g q12h
      • CrCl 10-19: 1g q24h
      • CrCl <10: 500mg-1g q24h
      • Hemodialysis: Administer dose after dialysis
    • Pediatric
      • Renal impairment requires interval extension based on GFR
  • Hepatic
    • No adjustment defined

Contraindications

  • Allergy to class/drug (Oxacephems or Cephalosporins)
  • History of anaphylactic shock

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: ~50 minutes (Flomoxef)
  • Metabolism: Minimally metabolized
  • Excretion: Urine
  • Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis.
  • Structure Note: The sulfur atom in the dihydrothiazine ring of the cephalosporin nucleus is replaced by an oxygen atom. This substitution generally confers increased stability against beta-lactamases.

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 R
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae S
N. meningitidis S
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 I
Serratia marcescens I
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii I
Citrobacter diversus S
Citrobacter sp. I
Aeromonas sp S
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica S
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida X1
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp R
Mycobacterium avium R
Anaerobes Actinomyces X1
Bacteroides fragilis S
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum S
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 / Japanese Journal of Antibiotics
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