Ostermayer: Created page with "==General== Type: Is Generation::3rd generation Is DrugClass::Cephalosporin Dosage Forms: powder for injection Dosage Strengths: 500mg, 1g Routes of Administration: IV, IM Common Trade Names: Sepatren, Suncefal ==Adult Dosing== ===General=== Standard: 1-2g IM/IV q12h Severe: 2g IM/IV q12h (or divided q8h in rare cases) Max: 4g/day ===Pneumonia / Respiratory Tract Infections=== 1g IM/IV q12h Effective against Pseudomonas aeruginosa in respirato..."

2026-01-28T19:58:23Z

Created page with "==General== *Type: Is Generation::3rd generation Is DrugClass::Cephalosporin *Dosage Forms: powder for injection *Dosage Strengths: 500mg, 1g *Routes of Administration: IV, IM *Common Trade Names: Sepatren, Suncefal ==Adult Dosing== ===General=== *Standard: 1-2g IM/IV q12h *Severe: 2g IM/IV q12h (or divided q8h in rare cases) *Max: 4g/day ===Pneumonia / Respiratory Tract Infections=== *1g IM/IV q12h *Effective against Pseudomonas aeruginosa in respirato..."

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==General==
*Type: [[Is Generation::3rd generation]] [[Is DrugClass::Cephalosporin]]
*Dosage Forms: powder for injection
*Dosage Strengths: 500mg, 1g
*Routes of Administration: IV, IM
*Common Trade Names: Sepatren, Suncefal

==Adult Dosing==
===General===
*Standard: 1-2g IM/IV q12h
*Severe: 2g IM/IV q12h (or divided q8h in rare cases)
*Max: 4g/day

===[[Pneumonia]] / Respiratory Tract Infections===
*1g IM/IV q12h
*Effective against [[Pseudomonas aeruginosa]] in respiratory infections

===[[UTI]], Complicated===
*1g IM/IV q12h

===Biliary Tract Infections===
*1g IM/IV q12h
*Achieves very high concentrations in the bile

==Pediatric Dosing==
===General===
*30-80mg/kg/day IM/IV divided q12h
*Severe Infections: Up to 150mg/kg/day IM/IV divided q6-12h
*Max: 4g/day

==Special Populations==
*Pregnancy: B
*Lactation: Excreted in breast milk; use with caution
*Renal
**Adult
***CrCl > 30: No adjustment necessary
***CrCl < 30: No adjustment usually necessary if hepatic function is normal (primarily biliary excretion)
***Hemodialysis: Give supplement after dialysis
**Pediatric
***Not routinely defined; generally no adjustment needed for renal impairment alone
*Hepatic
**Adult
***Significant hepatic dysfunction requires dosage reduction or extended interval (e.g., 1g q24h)
***Combined renal and hepatic dysfunction requires significant dose reduction and monitoring

==Contraindications==
*Allergy to class/drug (Cephalosporins)
*History of anaphylactic shock/severe reaction to Penicillin

==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*[[Clostridium difficile]]
*Hypoprothrombinemia (Bleeding tendency) due to N-methylthiotetrazole (MTT) side chain
*Disulfiram-like reaction (Alcohol intolerance)

===Common===
*[[Diarrhea]] (Higher incidence due to high biliary excretion)
*[[Rash]]
*[[Nausea and Vomiting]]
*[[Abdominal Pain]]
*Injection site pain/phlebitis
*Elevation of AST/ALT

==Pharmacology==
*Half-life: 4-5h (Long half-life compared to other cephalosporins)
*Metabolism: Minimally metabolized
*Excretion: Bile (Main route, ~70-80%), Urine (~20-30%)
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis.
*Side Chain Note: Contains N-methylthiotetrazole (MTT) ring associated with Vitamin K inhibition (bleeding risk) and disulfiram-like reactions.

==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''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||I
|-
| ||Serratia marcescens||I
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||'''S'''
|-
| ||[[Citrobacter freundii]]||I
|-
| ||[[Citrobacter diversus]]||'''S'''
|-
| ||[[Citrobacter sp.]]||I
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||'''S'''
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||'''S'''
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||'''S'''
|-
| ||[[Vibrio vulnificus]]||'''S'''
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||R
|-
| ||[[Mycobacterium avium]]||R
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||I
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||I
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}

===Key===
{{Template:Antibacterial Spectra Key}}

==See Also==
*[[Antibiotics (Main)]]

==References==
<references/>

[[Category:Pharmacology]] [[Category:ID]]

Cefpiramide - Revision history