1) Cephalosporins
Generation Common Dosages/Regimens
1st Cephalexin (Keflex) 250-500mg PO q6h
Cefazolin (Kefzol, Ancef) 1-2g IV q6-8h
2nd Cefuroxime axetil (Ceftin) 250-500mg PO q12h
Cefuroxime sodium (Zinacef) 750-1500mg IV q8h
Cefoxitin (Mefoxin) 1-2g IV/IM q6-8h
Cefotetan (Cefotan) 1-2g IV/IM q12h
3rd (called extended Cefixime (Suprax) 400mg PO q24h
spectrum Cefdinir (Omnicef) 300mg PO q12h or 600mg PO q24h
cephalosporins from Ceftazidime (Fortaz) 1-2g IV q8h
here on) Ceftriaxone (Rocephin) 1-2g IV q12-24h
 Ceftriaxone: biliary sludging in neonates, not
recommended in neonates (<28 days)
 Pain in abdomen n/v
4th generation Cefepime (Maxipime) 1-2g IV q8-12h
5th generation Ceftaroline (Teflaro) 600mg IV q12 Approved in 2010
Class Notes and ADR
 IgG/M mediated reaction to PCN: CAN give cephalosporins with caution
 if IgE mediated anaphylaxis: DO NOT give cephalosporins
 Most cephalosporins are renally eliminated (except Ceftriaxone liver)
If pt has allergy common practice if patient is truly allergic there is 5% cross
sensitivity, they can give cephalosporin.
Spectrum of Activity
G(+): MSSA, Streptococci
G(-): Proteus, E. coli, Klebsiella (PEK)
Clinical uses: skin/soft tissue infection, s
G(+): similar to 1st gen
G(-): PEK + (H. influenzae, Enterobacter,
Anaerobes: Bacteroides (cefotetan, cef
Clinical uses: upper respiratory infectio
prophylaxis
G(+): MSSA, Streptococcus
G(-): HEN PEK + Citrobacter, Salmonella
Pseudomonas: ceftazidime
Clinical uses: community and hospital a
G(+): MSSA, Streptococci
G(-): 3rd generation + Pseudomonas
Clinical uses: broad spectrum, empiric t
acquired infections
G(+): Streptococcus, MRSA
G(-): some coverage, lost Pseudomonas
Clinical uses: MRSA pneumonia, mixed M