Cephalosporins類抗生素 (一代)

Bone infections: caused by Staphylococcus aureus and/or Proteus mirabilis
Otitis media: caused by Streptococcus pneumoniae, Haemophilus influenzae, S. aureus, Streptococcus pyogenes, and Moraxella catarrhalis
Respiratory tract infections: infections including pharyngitis; caused by S. pneumoniae and S. pyogenes
Skin and soft tissue infections: caused by S. aureus and/or S. pyogenes
Urinary tract infections: genitourinary tract infections, including acute prostatitis; caused by Escherichia coli, P. mirabilis, and Klebsiella pneumoniae

Antibiotic, Cephalosporin (First Generation)

Hypersensitivity to cephalosporins

B (FDA); Cephalosporins are an alternative for group B streptococcus prophylaxis in pregnant patients who are penicillin allergic and at low risk for anaphylaxis; cephalexin may be used if an oral agent is appropriate

Infant risk is minimal, the milk/plasma ratios have varied from 0.01-0.16, disturbing bowel normal flora, interfering stool culture, or allergy to the antibiotic can occur.

1. Hypersensitivity: Rash, urticaria, angioedema, anaphylaxis, erythema multiforme, SJS, TEN have been reported
2. Elevated INR: Especially in nutritionally-deficient patients, prolonged treatment, hepatic or renal disease
3. Penicillin allergy: Use with caution in patients with a history of penicillin allergy (eg, anaphylaxis, angioedema, urticaria)
4. Seizure disorder: Use with caution in patients with a history of seizure disorder; high levels and renal impairment may increase risk of seizures
5. Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis

Skin and soft tissue infections:
1. Cellulitis/erysipelas: 500 mg 4 times daily for at least 5 days; should be extended up to 14 days if not resolved
2. Impetigo/ecthyma: 250 to 500 mg 4 times daily for 7 days
Urinary tract infections:
1. Acute: 250 to 500 mg every 6 hours for 5 to 7 days
2. Prophylaxis for recurrent infection: 125 to 250 mg once daily
Streptococcal pharyngitis, group A:
500 mg twice daily for 10 days

General dosing, susceptible infection:
1. Mild to moderate infection: 25 to 50 mg/kg/day divided every 6 to 12 hours; maximum 2,000 mg/day
2. Severe infection: 75 to 100 mg/kg/day divided every 6 to 8 hours; maximum 4,000 mg/day Acute otitis media:
(Children >1 year and Adolescents <15 years) 75 to 100 mg/kg/day divided every 6 hours; maximum dose not established for AOM.
Pneumonia, community-acquired:
(Infants >3 months, Children, and Adolescents) 75 to 100 mg/kg/day divided every 6 to 8 hours; maximum 4,000 mg/day
Skin and soft tissue infections:
1. Cellulitis/erysipelas: 25 to 100 mg/kg/day divided every 6 to 8 hours; maximum 500 mg/dose
2. Impetigo/ecthyma: 25 to 50 mg/kg/day divided every 6 to 8 hours; maximum 2,000 mg/day; Duration of treatment is 7 days
Urinary tract infections:
1. Mild to moderate: 25 to 50 mg/kg/day divided every 6 to 12 hours; maximum 500 mg/dose
2. Severe: 50 to 100 mg/kg/day divided every 6 to 8 hours; maximum 1,000 mg/dose
Streptococcal pharyngitis, group A:
40 mg/kg/day divided every 12 hours for 10 days; maximum 500 mg/dose

Altered kidney function:
1. CrCl ≥30 mL/minute: No dosage adjustment necessary.
2. CrCl 15-30 mL/minute: 250 to 500 mg every 8 to 12 hours.
3. CrCl <15 mL/minute: 250 to 500 mg every 12 to 24 hours.
Hemodialysis, intermittent (thrice weekly): Dialyzable (50%)
250 to 500 mg every 12 to 24 hours; administer after hemodialysis on dialysis days
Peritoneal dialysis: Limited clearance by peritoneal dialysis
250 to 500 mg every 12 to 24 hours

There are no dosing adjustments provided in the manufacturer's labeling.