II. Indications
- Abdominal Surgery prophylaxis
- Colorectal surgery prophylaxis
III. Mechanism
- Antibiotics in this group are Cephamycin derivatives
- Antibiotic coverage spectrum
- Gram Positive activity (but less than Second Generation Broad-spectrum Cephalosporins such as Cefuroxime)
- Gram Negative coverage
- Anaerobic coverage (e.g. Bacteroides)
IV. Dosing: Adult
- Typical Dose
- Give 1 to 2 g IV every 6 to 8 hours
- High Dose (Severe Infections)
- Give 3 g IV every 6 hours
- Surgical Prophylaxis
- Give 2 g IV 30 to 60 min before surgery (or for Cesarean Section, after Umbilical Cord clamped)
- May continue 2 g IV every 6 hours for 24 hours
-
Renal Dosing
- eGFR 30 to 50 ml/min: 1 to 2 g IV every 8 to 12 hours
- eGFR 10 to 29 ml/min: 1 to 2 g IV every 12 to 24 hours
- eGFR 5 to 9 ml/min: 0.5 to 1 g IV every 12 to 24 hours
- eGFR <5 ml/min: Load 1 to 2 g IV, then 0.5 g IV every 24 to 48 hours
- Give additional 1 to 2 g IV after Hemodialysis
V. Dosing: Child (age >3 months)
- Typical Dose
- Give 80 to 100 mg/kg/day IV divided every 6 to 8 hours
- High Dose (severe infections)
- Give 160 mg/kg/day IV divided every 6 to 8 hours
VI. Adverse Effects
- Lab abnormalities in children after high dose regimens
- Eosinophilia
- Aspartate Aminotransferase (AST) increased
VII. Safety
- Pregnancy Category B
- Safe in Lactation
VIII. Resources
IX. References
- (2012) Presc Lett, Resource #280706, Comparison of Cephalosporins
- Hamilton (2020) Tarascon Pocket Pharmacopoeia