Cephalosporins類抗生素 (二代)

Bacteremia/sepsis: caused by Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli, Klebsiella species, and Bacteroides species including B. fragilis
Bone and joint infections: caused by S. aureus
Gynecological infections: caused by E. coli, Neisseria gonorrhoeae, Bacteroides species including Bacteroides fragilis, Clostridium species, P. niger, Peptostreptococcus species, and Streptococcus agalactiae
Lower respiratory tract infections: Treatment of pneumonia and lung abscess, caused by S. pneumoniae, other streptococci, S. aureus, E. coli, Klebsiella species, Haemophilus influenzae, and Bacteroides species
Septicemia: caused by S. pneumoniae, S. aureus, E. coli, Klebsiella species, and Bacteroides species
Skin and skin structure infections: caused by S. aureus, Staphylococcus epidermidis, Streptococcus pyogenes and other streptococci, E. coli, Proteus mirabilis, Klebsiella species, Bacteroides species including B. fragilis, Clostridium species, P. niger, and Peptostreptococcus species
Urinary tract infections: Treatment of UTIs caused by E. coli, Klebsiella species, P. mirabilis, Morganella morganii, Proteus vulgaris, and Providencia species

Antibiotic, Cephalosporin

Absorption:
Bioavailability, rectal: Increases to 17% with sodium octanoate or sodium salicylate
Distribution:
1. Protein binding: 41% to 75%
2. Vd, obese adults: 18.9 L
3. Dialyzable: Yes (hemodialysis), 86%
Metabolism:
1. Hepatic: Less than 2%
2. Descarbamyl metabolite: Inactive
Excretion:
1. Bile: Less than 1%
2. Renal: 85% unchanged; Renal clearance: 299 mL/minute
3. Total body clearance, obese adults: 14.7 L/hr
Elimination Half Life:
41 to 59 minutes

Hypersensitivity reactions to cefoxitin or other cephalosporin antibiotics should not receive the drug.

B (FDA)

Infant risk is minimal

Common: thrombophlebitis, diarrhea
Serious: Erythema multiforme, Stevens-Johnson syndrome, Pseudomembranous enterocolitis, Anaphylaxis.

General: 1–2 g IV or IM Q6 - 8H
In severe infections: 2 g IV Q4H or 3 g IV Q6H

(>3 months of age and Children) 80 to 160 mg/kg/day in 3 to 6 equally divided doses. Maximum daily dosage is 12 g.

1. ClCr 30-50 mL/min: Administer 1-2 g Q 8-12H
2. ClCr 10-29 mL/minute: Administer 1-2 g Q12-24H
3. ClCr 5-9 mL/minute: Administer 0.5-1 g Q12-24H
4. ClCr <5 mL/minute: Administer 0.5-1 g Q24-48H