II. Mechanism: Spectrum of Activity

III. Preparations: Oral agents

  1. Cefixime (Suprax)
    1. Adult
      1. Standard: 400 mg PO divided qd to bid
      2. Gonorrhea: 400 mg PO for single dose
    2. Child: 8 mg/kg/day divided daily to twice daily
  2. Cefpodoxime (Vantin)
    1. Good activity Gram Positive organisms
      1. Covers Staphylococcus aureus
      2. Covers Pneumococcus
    2. Adult: 100 to 400 mg orally twice daily
    3. Child
      1. Pharyngitis: 10 mg/kg/day divided twice daily
      2. Otitis Media: 10 mg/kg/day taken daily
  3. Cefdinir (Omnicef)
    1. Age >13 years, Adult: 300 mg orally twice daily or 600 mg orally once daily
    2. Child <13 years old: 14 mg/kg/day divided once to twice daily

IV. Preparations: Parenteral agents

  1. Cefotaxime (Claforan)
    1. Most Staphylococcus aureus and Anaerobic activity
    2. Adult: 1 to 2 grams IM or IV every 6 to 8 hours
    3. Child
      1. Standard: 50-150 mg/kg/day IM or IV divided q4-6h
      2. Meningitis: 200 mg/kg/day IV divided q6-8h
      3. Maximum dose: 2 grams
  2. Ceftizoxime (Cefizox)
    1. Moderate Staphylococcus aureus and Anaerobic Activity
    2. Adult: 1 to 2 grams IV every 8 to 12 hours
    3. Child: 50 mg/kg/dose IV every 6 to 8 hours
  3. Ceftriaxone (Rocephin)
    1. Least Staphylococcus and Anaerobic activity
    2. Dilute in Lidocaine 1% for Intramuscular Injection
    3. In adults, 2 gram dose is preferred in >100 kg or critically ill patients
    4. Adult
      1. Standard: 1-2 grams IM or IV every 24 hours
      2. Gonorrhea: 250 mg IM single dose
    5. Child
      1. Standard: 50-75 mg/kg/day IV divided every 12-24 hours
      2. Meningitis: 100 mg/kg/day IV divided every 12-24 hours (twice daily is preferred)
      3. Otitis Media: 50 mg/kg IM single dose (max: 1g)
      4. Maximum Dose: 2 grams (4 grams for Meningitis)

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Cost: Medications

ceftriaxone (on 6/22/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CEFTRIAXONE 1 GM VIAL Generic $1.83 each
CEFTRIAXONE 500 MG VIAL Generic $0.97 each
cefpodoxime (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CEFPODOXIME 100 MG TABLET Generic $2.11 each
CEFPODOXIME 200 MG TABLET Generic $2.66 each
cefdinir (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CEFDINIR 125 MG/5 ML SUSP Generic $0.15 per ml
CEFDINIR 250 MG/5 ML SUSP Generic $0.17 per ml
CEFDINIR 300 MG CAPSULE Generic $0.44 each