Ceforanide

General

• Type: 2nd generation Cephalosporin
• Dosage Forms: powder for injection
• Dosage Strengths: 500mg; 1g, 10g
• Routes of Administration: IV, IM
• Common Trade Names: Precef

Adult Dosing

General

• 0.5-1g IM/IV q12h
• Max: 4g/day

UTI, Uncomplicated

• 0.5-1g IM/IV q12h

Community Acquired Pneumonia

• 0.5-1g IM/IV q12h

Surgical Prophylaxis

• 0.5-1g IM/IV 1 hour prior to surgery
• Intraoperative: May repeat during lengthy procedures (>2hr)
• Postoperative: 0.5-1g IM/IV q12h for 24h

Pediatric Dosing

General (>1 Year)

• 20-40mg/kg/day IM/IV divided q12h
• Max: 4g/day

Special Populations

• Pregnancy: B
• Lactation: Excreted in breast milk; use caution
• Renal
  • Adult
    • CrCl >60: Standard dosing (q12h)
    • CrCl 20-60: Give standard dose q24h
    • CrCl <20: Give standard dose q48h
    • Hemodialysis: Give supplement after dialysis
• Hepatic
  • No adjustment defined

Contraindications

• Allergy to class/drug (Cephalosporins)
• Caution in Penicillin allergy (cross-reactivity)

Adverse Reactions

Serious

• Anaphylaxis
• Stevens-Johnson Syndrome
• Clostridium difficile
• Hemolytic Anemia
• Neutropenia
• Thrombocytopenia

Common

• Injection site pain (IM) or phlebitis (IV)
• Diarrhea
• Rash
• Nausea and Vomiting
• Transient transaminitis
• Eosinophilia

Pharmacology

• Half-life: 2.9 - 3.0h
• Metabolism: Not metabolized
• Excretion: Urine (unchanged)
• Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities

Group	Organism	Sensitivity
Gram Positive	Strep. Group A, B, C, G	S
	Strep. Pneumoniae	S
	Viridans strep	S
	Strep. anginosus gp	X1
	Enterococcus faecalis	R
	Enterococcus faecium	R
	MSSA	S
	MRSA	R
	CA-MRSA	R
	Staph. Epidermidis	I
	C. jeikeium	R
	L. monocytogenes	R
Gram Negatives	N. gonorrhoeae	S
	N. meningitidis	S
	Moraxella catarrhalis	S
	H. influenzae	S
	E. coli	S
	Klebsiella sp	S
	E. coli/Klebsiella ESBL+	R
	E coli/Klebsiella KPC+	R
	Enterobacter sp, AmpC neg	I
	Enterobacter sp, AmpC pos	R
	Serratia sp	R
	Serratia marcescens	R
	Salmonella sp	S
	Shigella sp	S
	Proteus mirabilis	S
	Proteus vulgaris	I
	Providencia sp.	R
	Morganella sp.	R
	Citrobacter freundii	R
	Citrobacter diversus	I
	Citrobacter sp.	I
	Aeromonas sp	X1
	Acinetobacter sp.	R
	Pseudomonas aeruginosa	R
	Burkholderia cepacia	R
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	X1
	Francisella tularensis	X1
	Brucella sp.	X1
	Legionella sp.	R
	Pasteurella multocida	S
	Haemophilus ducreyi	X1
	Vibrio vulnificus	X1
Misc	Chlamydophila sp	R
	Mycoplasm pneumoniae	R
	Rickettsia sp	R
	Mycobacterium avium	R
Anaerobes	Actinomyces	S
	Bacteroides fragilis	R
	Prevotella melaninogenica	I
	Clostridium difficile	X1
	Clostridium (not difficile)	S
	Fusobacterium necrophorum	S
	Peptostreptococcus sp.	S

Key

• S susceptible/sensitive (usually)
• I intermediate (variably susceptible/resistant)
• R resistant (or not effective clinically)
• S+ synergistic with cell wall antibiotics
• U sensitive for UTI only (non systemic infection)
• X1 no data
• X2 active in vitro, but not used clinically
• X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
• X4 active in vitro, but not clinically effective for strep pneumonia

See Also

• Antibiotics (Main)