Cephalosporins

Question 1

Cephalosporins Pearls

Answer 1

Universal prescribing alerts:
Known serious allergic reaction: use with caution if the patient is allergic to penicillin agents due to cross-reaction.
Cephalosporins have been associated with seizures, especially in patients with renal impairment given unadjusted doses. Dosage reductions are recommended in these patients for certain cephalosporin agents.
Can cause false-positive urinary glucose if the patient is using cupric sulfate (Benedict’s solution, Clinitest, Fehling’s solution).

Question 2

Cefadroxil Usage

1st Generation

Answer 2

Pharyngitis or tonsillitis
Streptococcus pyogenes
Skin and skin structure infections caused by staphylococci or streptococci
Urinary tract infection (for example: E. coli, Proteus mirabilis, Klebsiella)

Question 3

Cefadroxil Dosage

1st Generation

Answer 3

Usual oral dose:

1 to 2 g daily as single dose or 2 divided doses

Question 4

Cefadoxil Pearls

1st Generation

Answer 4

Use with caution in patients with colitis due to increased absorption
Monitor: renal function

Question 5

Cefazolin Usage

1st Generation

Answer 5

Treatment of susceptible bacteria that cause biliary tract infections, bone and joint infections, endocarditis, genital infections, respiratory tract infections, septicemia, skin and skin structure infections, and urinary tract infections (for example: E. coli, streptococci, P. mirabilis, Klebsiella, S. aureus, H. influenza)
Perioperative prophylaxis

Question 6

Cefazolin Dosage

1st Generation

Answer 6

Usual parenteral dose for treatment of endocarditis: IM/IV: 1 to 1.5 g ever 6 hours (max of 12 g per day)
Perioperative prophylaxis:
1 g, 30 to 60 minutes prior to surgery; additional doses are often required postoperatively depending on type of surgery (refer to PI for specific details)

Question 7

Cefazolin Pearls

1st Generation

Answer 7

May increase international normalized ration (INR)
High levels in patients with poor renal function can increase risk for seizures
Reconstitution of powder formulation is required prior to administration
Stability of reconstituted solution vary based on storage location (longer beyond use date when refrigerated; refer to PI
Suitable solutions for administration range in color from light yellow to yellow
Monitor: renal function, LFTs, CBC

Question 8

Cephalexin Usage

1st Generation

Answer 8

Treatment of susceptible gram-positive bacteria that cause respiratory tract infections, otitis media, skin and skin structure infections, bone infections, and genitourinary tract infections
Prophylaxis for acute infective endocarditis

Question 9

Cephalexin Dosage

1st Generation

Answer 9

Usual oral dose:

250 to 1000 mg every 6 hours (max 4 g per day)

Question 10

Cephalexin Pearls

1st Generation

Answer 10

May increase INR
Store suspension in the refrigerator
Monitor: renal, hepatic, and hematologic function with extended use