Cefaloridine

General

• Type: 1st generation Cephalosporin
• Dosage Forms: powder for injection
• Dosage Strengths: 250mg, 500mg, 1g
• Routes of Administration: IV, IM
• Common Trade Names: Ceporin, Loridine

Adult Dosing

General

• Mild-Moderate: 250-500mg IM/IV q6h
• Severe: 1g IM/IV q6h
• Max: 4g/day (Strict limit due to nephrotoxicity risk)

UTI, Uncomplicated

• 500mg IM/IV q6h

Endocarditis Prophylaxis

• 1g IM/IV x1 (30-60 min before procedure)

Pediatric Dosing

General

• 30-50 mg/kg/day IM/IV divided q6-8h
• Max: 4g/day

Special Populations

• Pregnancy: B
• Lactation: Excreted in breast milk; use caution
• Renal
  • Adult
    • CrCl 30-50: Max 3g/day
    • CrCl 10-29: Max 2g/day
    • CrCl <10: Max 1g/day
    • Note: Highly nephrotoxic; avoid in pre-existing renal impairment if possible.
  • Pediatric
    • Not well defined; avoid use.
• Hepatic
  • No adjustment usually required

Contraindications

• Allergy to class/drug
• Pre-existing significant renal impairment (Relative)

Adverse Reactions

Serious

• Nephrotoxicity (Dose-dependent proximal tubular necrosis)
• Anaphylaxis
• Neutropenia
• Leukopenia
• Seizures (accumulation in renal failure)
• Clostridium difficile

Common

• Rash
• Urticaria
• Nausea and Vomiting
• Injection site pain/phlebitis
• Pruritus
• Eosinophilia

Pharmacology

• Half-life: 1.1-1.5h
• Metabolism: Not significantly metabolized
• Excretion: Urine (glomerular filtration)
• Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities

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	R
	Moraxella catarrhalis	I
	H. influenzae	I
	E. coli	S
	Klebsiella sp	S
	E. coli/Klebsiella ESBL+	R
	E coli/Klebsiella KPC+	R
	Enterobacter sp, AmpC neg	R
	Enterobacter sp, AmpC pos	R
	Serratia sp	R
	Serratia marcescens	R
	Salmonella sp	X1
	Shigella sp	X1
	Proteus mirabilis	S
	Proteus vulgaris	R
	Providencia sp.	R
	Morganella sp.	R
	Citrobacter freundii	R
	Citrobacter diversus	R
	Citrobacter sp.	R
	Aeromonas sp	R
	Acinetobacter sp.	R
	Pseudomonas aeruginosa	R
	Burkholderia cepacia	R
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	R
	Francisella tularensis	X1
	Brucella sp.	X1
	Legionella sp.	R
	Pasteurella multocida	X1
	Haemophilus ducreyi	X1
	Vibrio vulnificus	X1
Misc	Chlamydophila sp	X1
	Mycoplasm pneumoniae	X1
	Rickettsia sp	X1
	Mycobacterium avium	R
Anaerobes	Actinomyces	X1
	Bacteroides fragilis	R
	Prevotella melaninogenica	X1
	Clostridium difficile	X1
	Clostridium (not difficile)	X1
	Fusobacterium necrophorum	X1
	Peptostreptococcus sp.	X1

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

• Antibiotics (Main)