Cefcapene

General

• Type: 3rd generation Cephalosporin
• Dosage Forms: Tablet, Fine Granules
• Dosage Strengths: 75mg, 100mg; 10% Granules (100mg/g)
• Routes of Administration: PO
• Common Trade Names: Flomox

Adult Dosing

General

• Standard: 100mg PO q8h (TID)
• Refractory/Severe: 150mg PO q8h (TID)
• Administer after meals
• Max: 450-600mg/day

Respiratory Tract Infections (Pneumonia, Bronchitis)

• 100-150mg PO q8h

UTI, Uncomplicated (Cystitis)

• 100mg PO q8h

Skin and Soft Tissue Infection

• 100mg PO q8h

Pediatric Dosing

General

• Standard: 3mg/kg PO divided q8h (TID)
• Refractory/Severe: May increase to 4.5mg/kg PO q8h
• Administer after meals
• Max: 600mg/day (or adult dose cap)

Special Populations

• Pregnancy: Safety not established (Use only if benefit outweighs risk)
• Lactation: Avoid or discontinue nursing (excreted in breast milk)
• Renal
  • Adult & Pediatric
    • Renal impairment delays excretion and increases serum half-life
    • Severe impairment (CrCl < 30): Extend dosing interval (e.g., q12h or q24h) or reduce dose.
    • Hemodialysis: Not fully defined, supplement likely required after dialysis.
• Hepatic
  • No specific adjustment defined; use with caution.

Contraindications

• Allergy to class/drug (Cephalosporins)
• History of anaphylactic shock to any ingredients
• Carnitine deficiency (due to pivoxil group)

Adverse Reactions

Serious

• Anaphylaxis
• Stevens-Johnson Syndrome
• Toxic Epidermal Necrolysis
• Clostridium difficile / Pseudomembranous colitis
• Hypocarnitinemia (associated with hypoglycemia and encephalopathy, especially in children)
• Agranulocytosis

Common

• Diarrhea / Loose stools (High incidence)
• Abdominal Pain
• Nausea
• Rash / Eruption
• Gastric discomfort
• Eosinophilia
• Elevation of AST/ALT

Pharmacology

• Half-life: 0.8 - 1.3h (Extended in renal failure)
• Metabolism: Hydrolyzed during absorption through intestinal wall to active metabolite (cefcapene); produces pivalic acid
• Excretion: Urine (approx 40% as active metabolite)
• 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	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.	I
	Citrobacter freundii	R
	Citrobacter diversus	I
	Citrobacter sp.	R
	Aeromonas sp	I
	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	R
	Prevotella melaninogenica	I
	Clostridium difficile	R
	Clostridium (not difficile)	I
	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

• Antibiotics (Main)