CEPHALOTHIN

Antibacterial activity

Cephalosporins, first generation
Gram-positive cocci (except ORSA/MRSA and enteroccocus species)
Gram negative bacilli ( E. coli, klebsiella, p. mirabillis)

Pregnancy Risk Factor

Class B

Contraindication/Precaution

Hypersensitivity to cephalothin, other cephalosporins or any component
Use caution if previous penicillins hypersensitivity:  10% of patient may have cross-hypersensitivity to cephalosporins
Use caution with nursing mothers
Use caution if renal dysfunction or if other nephrotoxic agents present
Use caution if history of ATB related colitis

Mechanism of Action

Inhibits cell wall synthesis (bactericidal)

Pharmacodynamics

Metabolism: liver and kidney
Half-life: 0.5-1 hours, changes with renal function
Elimination: excreted in urine

Dosage

Children: (max 10 g/d)

Body weight < 2000 g 0-7 days old:  20 mg/kg IM/IVq12h 8-28 days old:  20 mg/kg IM/IV q8h Body weight > 2000 g
0-7 days old:  20 mg/kg IM/IV q8h
8-28 days old:  20 mg/kg IM/IV q6h
> 28 days old:  75-125 mg/kg/day div IM/IV q4-6h

Adults:

Bacterial infections:
500-1000 mg IM/IV q4-6h
Prophylaxis:
1-2 g IM/IV given 30-60 min before surgery then q6h post-op

Dose VS renal function

Cr. clearance (ml/min):
<10: give q12h 10-50:give q6-8h 50-80: unchanged >80: unchanged

Dialysis
Hemo: N/A
CAPD: N/A