Names and pronunciation
(sef-try-ax′one)
Source page 258
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Individual generic drug information
Extracted information for cefTRIAXone only.
(sef-try-ax′one)
Source page 258
Func. class.: Broad-spectrum anti-infective
Source page 258
Chem. class.: Cephalosporin (third generation)
Source page 258
Do not confuse: cefTAZidime/ceftizoxime
Source page 258
ACTION: Inhibits bacterial cell wall synthesis, renders cell wall osmotically unstable, leads to cell death
Source page 258
USES: cefdinir: community-acquired pneumonia, otitis media, sinusitis, pharyngitis, skin and skin structure infections, acute exacerbations of chronic bronchitis, pneumonia, tonsillitis, Citrobacter diversus, Escherichia coli, Kleb- siella pneumoniae, Proteus mirabilis, Staphylococcus epidermidis, Streptococcus agalactiae (group B), viridans streptococci alpha, Haemophilus influenzae, Haemophi- lus parainfluenzae, Moraxella catarrhalis; gram-positive organisms: Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus (MSSA) cefditoren pivoxil: acute bacterial exacerba- tions of chronic bronchitis caused by Hae- mophilus influenzae, Haemophilus para- influenzae, Streptococcus pneumoniae, Moraxella catarrhalis; pharyngitis/tonsillitis caused by Streptococcus pyogenes; uncom- plicated skin and skin structure infections caused by Staphylococcus aureus, Strepto- coccus pyogenes; community-acquired pneumonia, viridans streptococci cefixime: uncomplicated UTI (Escherichia coli, Proteus mirabilis), pharyngitis and tonsillitis (Streptococcus pyogenes), otitis media (Haemophilus influenzae), Moraxella catarrhalis, acute bronchitis and acute exacerbations of chronic bron- chitis (Streptococcus pneumoniae, H. influenzae), uncomplicated gonorrhea cefotaxime: Haemophilus influenzae, Haemophilus parainfluenzae, Esche- richia coli, Enterococcus faecalis, Neis- seria gonorrhoeae, Neisseria meningiti- dis, Proteus mirabilis, Klebsiella, Citrobacter, Serratia, Salmonella, Shi- gella, Pseudomonas; Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus; serious lower respiratory tract, urinary tract, skin, bone, gonococcal infections; bacteremia, septi- cemia, meningitis, skin, skin structure infections; CNS infections; perioperative prophylaxis, intraabdominal infections, PID, UTI, ventriculitis cefpodoxime: Bacteroides, Neisseria gonor- rhoeae, Haemophilus influenzae, Esche- richia coli, Proteus mirabilis, Klebsiella; gram-positive organisms: Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus; upper and lower respiratory tract, urinary tract, skin infections; otitis media; sexually transmitted diseases cefTAZidime: Haemophilus influenzae, Escherichia coli, Enterobacter aerogenes, Pseudomonas aeruginosa, Proteus mira- bilis, Klebsiella, Citrobacter, Enterobacter, Salmonella, Shigella, Acinetobacter, Bacte- roides fragilis, Neisseria, Serratia; Strepto- coccus pneumoniae, Streptococcus pyo- genes, Staphylococcus aureus; serious lower respiratory tract, urinary tract, skin, gynecologic, bone, joint, intraabdominal infections; septicemia, meningitis ceftibuten: pharyngitis/tonsillitis, otitis media, secondary bacterial infection of acute bronchitis cefTRIAXone: gram-negative bacilli: Hae- mophilus influenzae, Escherichia coli, Enterobacter aerogenes, Proteus mirabilis, Klebsiella, Citrobacter, Enterobacter, Salmo- nella, Shigella, Acinetobacter, Bacteroides fragilis, Neisseria, Serratia; gram-positive organisms: Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus; serious lower respiratory tract, uri- nary tract, skin, gonococcal, intraabdominal infections; septicemia, meningitis, bone, joint infections; otitis media; PID
Source pages 258, 259
Extracted information for cefTRIAXone only.
CONTRAINDICATIONS: Hyper- sensitivity to cephalosporins, infants <1 mo Precautions: Pregnancy, breastfeeding, children, hypersensitivity to penicillins, GI/renal disease, geriatric patients, pseu- domembranous colitis, viral infection, vitamin K deficiencies, diabetes
Source page 259
SIDE EFFECTS CNS: Headache, dizziness, seizures GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, CDAD; cho- lestasis (cefotaxime) GU: Renal failure HEMA: Thrombocytopenia, agranulocyto- sis, neutropenia, lymphocytosis, eosino- philia, pancytopenia, hemolytic anemia INTEG: Rash, urticaria, dermatitis, injec- tion site reaction MS: Arthralgia (cefditoren) SYST: Anaphylaxis, serum sickness, Stevens-Johnson syndrome, toxic epi- dermal necrolysis
Source page 264
INTERACTIONS Many products should not be used with calcium salts (mixed or administered) or H2 blocker antacids (PO) Increase: bleeding—anticoagulants, thrombolytics, NSAIDs (ceftriaxone) Increase: toxicity—aminoglycosides, furo semide loop diuretics, probenecid Decrease: absorption of cefdinir—iron Drug/Food Decrease: absorption—iron-rich cereal, infant formula Drug/Lab Test Increase: ALT, AST, alkaline phosphatase, LDH, bilirubin, BUN, creatinine increase: creatinine (serum False urine), urinary 17-KS False positive: urinary protein, direct Coombs’ test, urine glucose Interference: cross-matching
Source page 264
Extracted information for cefTRIAXone only.
DOSAGE AND ROUTES cefdinir Uncomplicated skin and skin structure infections/community- acquired pneumonia • Adult and child ≥13 yr: PO 300 mg q12hr × 10 days or 600 mg q24hr • Child 6 mo-12 yr: PO 7 mg/kg q12hr or 14 mg/kg q24hr × 10 days Acute exacerbations of chronic bronchitis/acute maxillary sinusitis • Adult and child ≥13 yr: PO 300 mg C q12hr or 600 mg q24hr × 10 days Pharyngitis/tonsillitis • Adult and child ≥13 yr: PO 300 mg q12hr or 600 mg q24hr × 10 days • Child 6 mo-12 yr: PO 7 mg/kg q12hr × 5-10 days or 14 mg/kg q24hr × 10 days Renal dose • Adult/child >13 yr: PO CCr <30 mL/ min, 300 mg/day (adult); 7 mg/kg/day (child 6 mo-12 yr)
Source page 259
Available forms: Capsules 300 mg; suspension 125 mg, 250 mg/5 mL cefditoren • Adult: PO 200-400 mg bid × 10-14 days Renal dose • Adult: PO CCr 30-49 mL/min, max 200 mg bid; CCr <30 mL/min, max 200 mg daily Available forms: Tablets 200, 400 mg cefepime Febrile neutropenia • Adult/adolescent >16 yr/child ≥40 kg: IV 2 g q8hr × 7 days or until neutro- penia resolves • Infant ≥2 mo/child/adolescent ≤16 yr and ≤40 kg: IV 50 mg/kg/dose q8hr × 7 days or until neutropenia resolves Urinary tract infections (mild to moderate) • Adult/adolescent >16 yr: IV/IM 0.5-1 g q12hr × 7-10 days Urinary tract infections (severe) • Adult/adolescent >16 yr/ IV 2 g q12hr × 10 days Pneumonia (moderate to severe) • Adult: IV 1-2 g q 8-12hr × 10 days • Infant 2-11 mo/child/adolescent: IV 50 mg/kg/dose q12hr (max: 2 g/dose) × 10 days • Infant 1 mo (unlabeled): IV 50 mg/kg/ dose q12hr • Neonates ≥36 wk gestation (unla- beled): IV 50 mg/kg/dose q12hr • Neonates <36 wk gestation (unla- beled): IV 30 mg/kg/dose q12hr Complicated intraabdominal infections (peritonitis), biliary tract infections (cholangitis, cholecystitis) • Adults/adolescents 17 yr: IV 2 g q12hr with metronidazole × 7-10 days; for infec- tions caused by Pseudomonas aeruginosa, 2 g q8hr • Infants/child/adolescent 13-16 yr (unla- beled): IV 50 mg/kg/dose q12hr (max: 2 g/ dose) with metronidazole × 7-10 days; for infections caused by Pseudomonas aerugi- nosa, 50 mg/kg/dose q8hr (max: 2 g/dose) • Neonates ≥36 wk gestation (unla- beled): IV 50 mg/kg/dose q12hr with met- ronidazole × 7-10 days • Neonates <36 wk gestation (unla- beled): IV 30 mg/kg/dose q12hr with metronidazole × 7-10 days Available forms: Powder for injection 500 mg, 1, 2 g; 1 g/50 mL, 2 g/100 mL Moderate-severe skin/structure infections due to Staphylococcus aureus or Streptococcus pyogenes or for diabetic foot ulcer (unlabeled) cefixime • Adult/adolescent/child >12 yr old >45 kg: PO 400 mg/day divided q12-24hr • Child ≤45 kg/infant ≥6 mo: PO 8 mg/ kg/day divided q12-24hr Renal dose • Adult: PO CCr 21-59 mL/min, give 65% of dose; CCr <20 mL/min, give 50% of dose Available forms: Powder for oral sus- pension 100 mg/5 mL, 200 mg/5 mL, 500 mg/mL; chewable tablets 100, 200 mg; capsules 400 mg cefotaxime • Adult/adolescent/child ≥50 kg: IV/IM (uncomplicated infections) 1 g q12hr, (moderate-severe infection) 1-2 g q8hr, (severe infections) 2 g q6-8hr, (life-threat- ening infections) 2 g q4hr, max 12 g/day • Adolescent/child <50 kg and infants: IV/IM 50-180 mg/kg/day divided q6-8hr, max 2 g/dose; (severe infections) 200- 225 mg/kg/day divided q4-6hr, max 12 g • Neonate >7 days: IV/IM 50 mg/kg/ dose q8-12hr Uncomplicated gonorrhea • Adult: IM 500 mg as a single dose Rectal gonorrhea Adult: Men IM 1 g as a single dose Adult: Women IM 500 mg as a single dose Renal dose • Adult: IM CCr <20 mL/min 50% dose reduction Available forms: Powder for injection 500 mg, 1, 2, 10 g; injection 1, 2 g pre- mixed frozen cefpodoxime Pneumonia • Adult/child >12 yr: PO 200 mg q12hr × 14 days Chronic bronchitis • Adult/child ≥12 yr: PO 200 mg q12hr × 10 days Uncomplicated gonorrhea • Adult/child ≥12 yr: PO 200 mg as a single dose Acute maxillary sinusitis • Adult/child ≥12 yr: PO 200 mg q12hr × 10 days • Child 2 mo-12 yr: PO 5 mg/kg q12hr × 10-14 days Skin and skin structure • Adult/child >12 yr: PO 400 mg q12hr × 7-14 days Pharyngitis and tonsillitis • Adult/child >12 yr: PO 100 mg q12hr × 5-10 days • Child 5 mo-12 yr: PO 5 mg/kg q12hr (max 100 mg/dose or 200 mg/day) × 5-10 days Uncomplicated UTI • Adult/child >12 yr: PO 100 mg q12hr × 7 days; dosing interval increased with severe renal impairment Acute otitis media • Child 2 mo-12 yr: PO 5 mg/kg q12hr × 5 days Available forms: Tablets 100, 200 mg; granules for suspension 50 mg, 100 mg/5 mL cefTAZidime • Adult/child >12 yr: IV/IM 1-2 g q8hr • Child: IV/IM 30-50 mg/kg q8hr, max 6 g/day • Neonate: IV/IM 30-50 mg/kg q8-12hr Renal dose • Adult: IM/IV CCr 31-50 mL/min 1 g q12hr; CCr 16-30 mL/min 1 g q24hr; CCr 6-15 mL/ min 1-g loading dose, then 0.5 g q24hr; CCr <5 mL/min 1-g loading dose, then 0.5 g q48hr Available forms: Injection 500 mg, 1, 2, 6 g/vial cefTRIAXone UTI, lower respiratory infections, bone joint, skin/skin structure infections • Adult/child >12 yr: IM/IV 1-2 g/day, max 4 g/24 hr • Child ≤12 yr: IM/IV 50-75 mg/kg/day in equal doses q12-24hr Uncomplicated gonorrhea • Adult: 250 mg IM as single dose with azithromycin 1 g single dose or doxycy- cline 100 mg bid × 7 days • Reduce dosage in severe renal impair- ment (CCr <10 mL/min) Meningitis • Adult: IV 4 g/day divided every 12 to 24 hr × 7-21 days • Child: IV/IM 100 mg/kg/day × 7-14 days Available forms: Injection 250, 500 mg, 1, 2; infusion 1,2 g/50 mL Administer cefdinir • Oral suspension after adding 39 mL water to the 60-mL bottle or 65 mL water to the 120- mL bottle; discard unused portion after 10 days; give without regard to food, do not give within 2 hr of antacids, iron supplements • After C&S completed cefditoren • For 10-14 days to ensure organism death, prevent superinfection • With food; do not give with antacids • After C&S completed cefepime Intermittent IV INFUSION route • IV after diluting in 50-100 mL or more D5W, NS; give over 30 min • For 7-10 days to ensure organism death, prevent superinfection Y-site compatibilities: DOXOrubicin li- posome cefixime • For 10-14 days to ensure organism death, prevent superinfection • Without regard to food • Chew tablets before swallowing cefotaxime IV route • IV after diluting 1 g/10 mL D5W, NS, sterile water for injection, give over 3-5 min by Y-tube or 3-way stopcock; may be diluted further with 50-100 mL NS or D5W; run over ½-1 hr; discontinue pri- C mary infusion during administration; may be diluted in larger volume of solution, given as a continuous infusion • For 10-14 days to ensure organism death, prevent superinfection • Thaw frozen container at room tem- perature or refrigeration; do not force thaw by immersion or microwave; visu- ally inspect container for leaks Y-site compatibilities: Acyclovir, alfentanil, alprostadil, amifostine, amikacin, aminoca- proic acid, aminophylline, anidulafungin, ascorbic acid injection, atenolol, atracu- rium, atropine, aztreonam, benztropine, bivalirudin, bleomycin, bumetanide, buprenorphine, butorphanol, caffeine, cal- cium chloride/gluconate, CARBOplatin, cefamandole, cefmetazole, cefonicid, cefo- perazone, cefoTEtan, cefOXitin, cefTAZi- dime (l-arginine), cefTRIAXone sodium, cefuroxime, cimetidine, CISplatin, clindamycin, codeine, cyanocobalamin, cyclophosphamide, cycloSPORINE, cytara- bine, DACTINomycin, DAPTOmycin, dexa- methasone, dexmedetomidine, digoxin, diltiaZEM, DOCEtaxel, DOPamine, doxacu- rium, doxycycline, enalaprilat, ePHEDrine, EPINEPHrine, epiRUBicin, epoetin alfa, eptifibatide, erythromycin, esmolol, etopo- side, famotidine, fenoldopam, fentaNYL, fludarabine, fluorouracil, folic acid, furosemide, gatifloxacin, gentamicin, glycopyrrolate, granisetron, heparin, hydrocortisone, HYDROmorphone, ifos- famide, imipenem-cilastatin, insulin (regu- lar), isoproterenol, ketorolac, lidocaine, linezolid, LORazepam, LR, magnesium sul- fate, mannitol, mechlorethamine, melpha- lan, meperidine, metaraminol, methicillin, methotrexate, methoxamine, methyldopate, metoclopramide, metoprolol, metroNIDA- ZOLE, mezlocillin, miconazole, midazolam, milrinone, minocycline, mitoXANTRONE, morphine, moxalactam, multiple vitamins, mycophenolate, nafcillin, nalbuphine, nal- oxone, nesiritide, netilmicin, nitroglycerin, nitroprusside, norepinephrine, normal saline, octreotide, ofloxacin, ondansetron, ornidazole, oxacillin, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pamidronate, pancuronium, pantoprazole, papaverine, pefloxacin, PEMEtrexed, penicillin G potas- sium/sodium, pentamidine, pentazocine, PENTobarbital, peritoneal dialysis solution, perphenazine, PHENobarbital, phenyleph- rine, phenytoin, phytonadione, piperacillin, polymyxin B, potassium chloride, procain- amide, prochlorperazine, promethazine, propofol, propranolol, protamine, pyridox- ine, quiNIDine, quinupristin, raNITIdine, remifentanil, Ringer’s injection, ritodrine, riTUXimab, rocuronium, sargramostim, sodium acetate/bicarbonate, sodium fusi- date, sodium lactate, succinylcholine, SUF- entanil, sulfamethoxazole-trimethoprim, tacrolimus, teniposide, theophylline, thia- mine, thiotepa, ticarcillin, ticarcillin-clavu- lanate, tigecycline, tirofiban, TNA, tobramy- cin, tolazoline, TPN, trastuzumab, trimetaphan, urokinase, vancomycin, vaso- pressin, vecuronium, verapamil, vinorel- bine, voriconazole cefpodoxime • Do not break, crush, or chew tablets due to taste • For 10-14 days to ensure organism death, prevent superinfection • With food for better absorption; do not give within 2 hr of antacids, H2-re- ceptor antagonists • Shake suspension well, refrigerate, discard after 2 wk cefTAZidime IM route • Fortaz, vials: reconstitute 500 mg or 1 g with 1.5 or 3 mL, respectively, of sterile or bacteriostatic water for injection or 0.5%-1% lidocaine (approx 280 mg/mL) • Tazicef vials: reconstitute 1 g/3 mL ster- ile water for injection (approx 280 mg/mL) • Withdraw dose while making sure needle remains in vial; ensure no CO2 bubbles present; inject deeply in large muscle mass, aspirate before injection IV route • Visually inspect for particulate matter, discoloration, if possible • Fortaz, Tazicef packs: reconstitute 1 or 2 g/100 mL sterile water for injection or other compatible IV solution (10 or 20 mg/mL, respectively); reconstitution is done in 2 stages: first, inject 10 mL of the diluent into the pack and shake well to dissolve and become clear; CO2 pres- sure inside container will occur, insert vent needle to release pressure; add remaining diluents, remove vent needle • Fortaz, Tazicef vials: reconstitute 500 mg, 1 g, 2 g with 5, 10 mL, respectively, of sterile water for injection or other compatible IV solution (100, 95-100, or 170-180 mg/mL, respectively); shake well to dissolve • Fortaz, ADD-Vantage vials (for IV only): reconstitute 1 or 2 g with NS, ½ NS, D5W in either 50- or 100-mL flexible di- luent container; to release CO2 pressure, insert vent needle after dissolving, re- move vent before using Direct intermittent IV INFUSION route • Vials: withdraw dose while making sure needle remains in solution; make sure there are no CO2 bubbles in syringe before injection; inject directly over 3-5 min or slowly into tubing of a free-flowing compatible IV solution Intermittent IV INFUSION route • Vials: withdraw dose while making sure needle opening remains in solution; make sure there are no CO2 bubbles in syringe before injection; infusion packs and ADD-Vantage systems ready for infusion after reconstitution, infuse over 15-30 min Y-site compatibilities: Acyclovir, alfent- anil, allopurinol, amifostine, amikacin, aminocaproic acid, aminophylline, amphotericin B lipid complex, anakinra, anidulafungin, atenolol, atropine sulfate, aztreonam, benztropine, bivalirudin, bleo- mycin, bumetanide, buprenorphine, butorphanol, calcium gluconate, CARBO- platin, cefamandole, ceFAZolin, cefonicid, cefoperazone, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cefTRIAXone, cefuroxime, cephalothin, cephapirin, cimetidine, ciprofloxacin, CISplatin, clindamycin, codeine, cyanocobalamin, cyclophosphamide, cycloSPORINE, cytara- bine, DACTINomycin, DAPTOmycin, dexa- methasone, dexmedetomidine, digoxin, diltiaZEM, DOCEtaxel, DOPamine, doxa- curium, doxapram, enalaprilat, ePHED- rine, EPINEPHrine, epoetin alfa, eptifiba- tide, esmolol, etoposide, famotidine, fenoldopam, fentaNYL, filgrastim, fludara- bine, fluorouracil, folic acid, foscarnet, furosemide, gallium, gatifloxacin, gem- citabine, gentamicin, glycopyrrolate, granisetron, heparin, HYDROmorphone, ifosfamide, imipenem-cilastatin, indo- methacin, insulin (regular), irinotecan, isepamicin, isoproterenol, isosorbide, ketamine, ketorolac, labetalol, levoFLOXa- cin, lidocaine, linezolid, LORazepam, LR, magnesium sulfate, mannitol, mechlor- ethamine, melphalan, meperidine, meta- raminol, methicillin, methotrexate, meth- oxamine, methyldopate, methylPREDNISolone, metoclopramide, metoprolol, metroNIDAZOLE, miconazole, milrinone, morphine, moxalactam, multi- ple vitamins inj, nafcillin, nalbuphine, PACLitaxel, raNITIdine, remifentanil, tacrolimus, teniposide, theophylline, thio- tepa, vinorelbine, zidovudine cefTRIAXone • For 7-14 days to ensure organism death, prevent superinfection • IM inject deeply in large muscle mass IV route • IV after reconstituting 250 mg/2.4 mL, 500 mg/4.8 mL, 1 g/9.6 mL, 2 g/19.2 mL D5W, water for injection, 0.9% NaCl; fur- ther dilute with 50-100 mL (40 mg/mL) NS, D5W, D10W; shake; run over ½ hr • Do not mix with calcium salts Y-site compatibilities: Acetaminophen, acyclovir, alfentanil, allopurinol, amifos- tine, amikacin, aminocaproic acid, ami- nophylline, amiodarone, amphotericin B liposome, anidulafungin, argatroban, atenolol, atracurium, atropine, aztreo- nam, benztropine, bivalirudin, bleomy- cin, bumetanide, buprenorphine, butor- phanol, CARBOplatin, cefamandole, ceFAZolin, cefmetazole, cefonicid, cefoperazone, cefoTAXime, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cefuroxime, cephalothin, cephapirin, cimetidine, cisatracurium, CISplatin, codeine, cyanocobalamin, cyclophos- C phamide, cycloSPORINE, cytarabine, DACTINomycin, DAPTOmycin, dexameth- asone, dexmedetomidine, digoxin, diltia- ZEM, DOCEtaxel, DOPamine, doxacu- rium, DOXOrubicin liposomal, doxycycline, drotrecogin alfa, enala- prilat, ePHEDrine, EPINEPHrine, epoetin alfa, eptifibatide, erythromycin, esmolol, etoposide, fenoldopam, fludarabine, flu- orouracil, folic acid, foscarnet, furose- mide, gallium, gatifloxacin, gemcitabine, gentamicin, glycopyrrolate, granisetron, heparin, hydrocortisone, HYDROmor- phone, ifosfamide, indomethacin, insulin (regular), isoproterenol, ketorolac, lan- soprazole, levoFLOXacin, lidocaine, line- zolid, LORazepam, mannitol, mechlor- ethamine, melphalan, meperidine, metARAMinol, methicillin, methotrexate, methoxamine, methyldopate, methyl- PREDNISolone, metoclopramide, meto- prolol, metroNIDAZOLE, mezlocillin, miconazole, midazolam, milrinone, mor- phine, moxalactam, multiple vitamins injection, nafcillin, nalbuphine, nalox- one, nesiritide, netilmicin, nitroglycerin, nitroprusside, norepinephrine, octreo- tide, oxacillin, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pamidronate, pancuronium, pantoprazole, PEME- trexed, penicillin G potassium/sodium, PHENobarbital, phenylephrine, phytona- dione, piperacillin, polymyxin B, potas- sium chloride, procainamide, propofol, propranolol, pyridoxine, raNITIdine, remifentanil, ritodrine, riTUXimab, rocuronium, sargramostim, sodium ace- tate/bicarbonate, succinylcholine, SUF- entanil, tacrolimus, teniposide, theophyl- line, thiamine, thiotepa, ticarcillin, ticarcillin-clavulanate, tigecycline, tirofi- ban, tolazoline, trastuzumab, trimetaphan, urokinase, vasopressin, vecuronium, verapamil, vinCRIStine, voriconazole, warfarin, zidovudine
Source pages 259, 260, 261, 262, 263
Extracted information for cefTRIAXone only.
Assess: • Infection: characteristics of wounds, sputum, urine, stool, WBC >10,000/ mm3, fever; obtain baseline and periodi- cally during treatment • Cross-sensitivity to penicillin, other cephalosporins; hypersensitivity reaction may occur • Obtain C&S prior to treatment, may start treatment before results are received • Blood studies: AST, ALT, CBC, Hct, biliru- bin, LDH, alkaline phosphatase, Coombs’ test monthly if patient is on long-term therapy • Electrolytes: potassium, sodium, chloride monthly if patient is on long-term therapy • CDAD: bowel pattern daily; if severe diarrhea occurs, product should be dis- continued • IV site for extravasation, phlebitis • Anaphylaxis: rash, urticaria, pruritus, chills, fever, joint pain, angioedema; may occur a few days after therapy begins • Serious skin disorders: Rash, blis- ters; toxic epidermal necrolysis, Stevens- Johnson syndrome may occur • Overgrowth of infection: perineal itching, fever, malaise, redness, pain, swelling, drainage, rash, diarrhea, change in cough, sputum
Source pages 264, 265
Evaluate: • Therapeutic response: decreased symptoms of infection; negative C&S
Source page 265
CLINICAL CONSIDERATIONS
Source page 264
Patient and caregiver information: • If diabetic, to check blood glucose • To report sore throat, bruising, bleed- ing, joint pain, may indicate blood dys- crasias (rare); diarrhea with mucus, blood, may indicate CDAD • To complete full course of treatment, to take missed dose as soon as remembered unless close to next dose, do not double dose; to use calibrated device for suspension • May turn stools red TREATMENT OF ANAPHY- LAXIS: EPINEPHrine, antihistamines; resuscitate if needed
Source page 265
Extracted information for cefTRIAXone only.
PHARMACOKINETICS cefdinir Unchanged in urine; crosses placenta, blood-brain barrier; eliminated in breast milk, not metabolized; 60%-70% protein binding, half-life 1.7 hr cefditoren Well absorbed when broken down (pro- drug), wide distribution, half-life 100 min, onset rapid, peak 1.5-3 hr, duration 12 hr, 88% protein binding cefepime Peak 79 min; half-life 2 hr; 20% bound by plasma proteins; 90% excreted unchanged in urine; crosses placenta, blood-brain barrier; excreted in breast milk, not metabolized cefixime PO: Peak 2-8 hr, half-life 3-4 hr, 65%- 70% protein binding, 50% eliminated unchanged in urine, crosses placenta, excreted in breast milk cefotaxime Half-life 1 hr, 35%-65% is bound by plasma proteins, 40%-65% is elimi- nated unchanged in urine in 24 hr, 25% metabolized in the liver to active metab- olites, excreted in breast milk (small amounts) IM: Onset 30 min IV: Onset 5 min cefpodoxime Half-life 1-1.5 hr, 13%-38% bound by plasma proteins, 30% eliminated unchanged in urine in 8 hr, crosses pla- centa, excreted in breast milk cefTAZidime IM/IV: Half-life 1½-2 hr, 10% bound by plasma proteins, 80% eliminated un- changed in urine, crosses placenta, ex- creted in breast milk cefTRIAXone Half-life 6-9 hr, 58%-96% eliminated unchanged in urine, crosses placenta, excreted in breast milk IM: Peak 1½-4 hr IV: Peak 30 min
Source page 264
Filter the extracted dose blocks for this individual drug.
Uncomplicated skin and skin structure infections/community- acquired pneumonia
• Adult and child ≥13 yr: PO 300 mg q12hr × 10 days or 600 mg q24hr
Candidate age grouping · source page 259
Uncomplicated skin and skin structure infections/community- acquired pneumonia
• Child 6 mo-12 yr: PO 7 mg/kg q12hr or 14 mg/kg q24hr × 10 days Acute exacerbations of chronic bronchitis/acute maxillary sinusitis
Candidate age grouping · source page 259
Uncomplicated skin and skin structure infections/community- acquired pneumonia
• Adult and child ≥13 yr: PO 300 mg C q12hr or 600 mg q24hr × 10 days Pharyngitis/tonsillitis
Candidate age grouping · source page 259
Uncomplicated skin and skin structure infections/community- acquired pneumonia
• Adult and child ≥13 yr: PO 300 mg q12hr or 600 mg q24hr × 10 days
Candidate age grouping · source page 259
Uncomplicated skin and skin structure infections/community- acquired pneumonia
• Child 6 mo-12 yr: PO 7 mg/kg q12hr × 5-10 days or 14 mg/kg q24hr × 10 days Renal dose
Candidate age grouping · source page 259
Uncomplicated skin and skin structure infections/community- acquired pneumonia
• Adult/child >13 yr: PO CCr <30 mL/ min, 300 mg/day (adult); 7 mg/kg/day (child 6 mo-12 yr)
Candidate age grouping · source page 259