Ohio Dentist and Dental Hygienist Ebook Continuing Education

___________________________________________________________________________ Antibiotics Review

THE CEPHALOSPORINS (Continued)

Agent

Adult Dosing Range

Pediatric Dosing Range

Route

Common Side Effects

Comments

3rd Generation (Continued) Cefixime

400 mg/day in 1 or 2 doses

>6 mos and <45 kg: 8–20 mg/kg/day every 12 to 24 hrs Max: 400 mg/day >12 yrs or >50 kg: Use adult dosing 1 mo to 12 yrs and <50 kg: 50–225 mg/kg/day in 3 to 4 divided doses

PO Diarrhea, rash

Can interfere with some urine glucose tests.

Cefotaxime 1–2 g every 4 to 12 hrs

IV, IM Phlebitis at infusion site, rash, GI upset

Single dose can be given for GC. Transient arrhythmias have developed after administration of this agent through central venous catheter. Decreased absorption with antacids and H2 blockers. Can be given as a single dose for GC. Can interfere with some urine glucose tests. The L-arginine formulation should not be used in children. Can interfere with some urine glucose tests. Avoid in neonates with hyperbilirubinemia. Higher doses are used for meningitis. A ceftriaxone-calcium salt can precipitate in the gallbladder,

Cefpodoxime 100–400 mg every 12 hrs for 7 to 14 days

10 mg/kg/day in 2 divided doses

PO Diarrhea, nausea, vomiting

Ceftazidime 500–1,000 mg every 8 hrs

IV: 30–50 mg/kg every 8 hrs Max: 6 g/day AAP recommendation for IV: 90–200 mg/kg/day every 8 hours Max: 6 g/day 9 mg/kg/day Max: 400 mg/day for 10 days 50–100 mg/kg/day in 1 to 2 divided doses Max: 4 g/day

IV, IM Phlebitis at infusion site, rash, GI upset

Ceftibuten 400 mg every 24 hrs for 10 days Ceftriaxone IV, IM: 1–2 g every 12 to 24 hrs

PO Rash, GI upset, headache IV, IM Phlebitis at infusion site, rash

causing sonographically detectable abnormalities.

4th Generation Cefepime

IV: 1–2 g every 8 to 12 hrs IM: 0.5–1 g every 12 hrs 2 g every 8 hours for 7 to 10 days

IV, IM: 50 mg/kg every 8 to 12 hrs Not to exceed adult dosing

IV, IM Phlebitis at infusion site, GI upset

Can interfere with some urine glucose tests.

Cefiderocol

IV Phlebitis at infusion site, rash, GI upset

Can interfere with some urine glucose tests

5th Generation Ceftaroline fosamil

600 mg every 12 hours for 5 to 14 days

>2 mos to <2 yrs: 8 mg/kg dose every 8 hrs for 5 to 14 days >2 yrs to <18 yrs and <33 kg: 12 mg/kg/dose every 8 hrs for 5 to 14 days >2 yrs to <18 yrs and >33 kg: 400–600 mg every 8 to 12 hrs for 5 to 14 days

IV Phlebitis at infusion site, GI upset, headache

Slow IV infusion over 60 minutes. Can interfere with some urine glucose tests.

Ceftobiprole 500 mg every 8 hours —

IV Hyponatremia,

Approved for use in Canada but not the United States. Not for use in patients with ventilator-associated pneumonia.

phlebitis at infusion site, headache, nausea/vomiting

Prescribing information is given for comparison purposes only. The higher dosage ranges reflect dosages for more severe infections. Please consult the manufacturer’s package insert for the antibiotic for complete prescribing information, maximum dosages, and indications. GC = gonococcal infection. Source: [6; 16] Table 2

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