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==General==
== General ==
*Type: [[Is Generation::1st generation]] [[Is DrugClass::Cephalosporin]]
* '''Type:''' [[Is Generation::1st generation]] [[Is DrugClass::Cephalosporin]]
*Dosage Forms: powder for injection
* '''Dosage Forms:''' Intramammary suspension, Ophthalmic ointment
*Dosage Strengths: 500mg; 1, 2, 10, 20, 100, 300g
* '''Routes of Administration:''' Intramammary (IMM), Topical (Ophthalmic)
*Routes of Administration: IV, IM
* '''Common Trade Names:''' Cepravin
*Common Trade Names: Ancef
* '''Note:''' Cefalonium is a semi-synthetic cephalosporin used almost exclusively in **veterinary medicine**. It is widely used for "Dry Cow" therapy to treat and prevent mastitis. It is not approved for human use in most jurisdictions.


==Adult Dosing==
== Adult Dosing ==
===General===
=== General ===
*Mild: 250-500mg IM/IV 8h
* '''Human Systemic Dosing:''' Not established. Not indicated for human use.
*Mod-Severe: 500-1000mg IM/IV q6-8h
* '''Veterinary (Bovine) - Dry Cow Therapy:'''
*Life Threatening: 1-1.5g IM/IV q6h
** Infuse one syringe (250 mg) into the teat canal of each quarter immediately after the last milking of the lactation.
*Max: 12g/day
** Massage udder upwards to distribute the suspension.


===[[UTI]], Uncomplicated===
=== Ophthalmic (Veterinary) ===
*1g IM/IV q12
* Apply a small amount (~1 cm) of ointment to the conjunctival sac q8–12h or as directed for infectious keratoconjunctivitis.


===Pneumococcal [[Pneumonia]]===
== Pediatric Dosing ==
*500mg IM/IV q12
* '''Safety and Efficacy:''' Not applicable (Veterinary drug).


===[[Endocarditis]] Prophylaxis, Dental===
== Special Populations ==
*1g IM/IV x1 (30-60 min before procedure)
* '''Pregnancy/Lactation (Humans):''' No data available.
* '''Veterinary Lactation (Withdrawal Periods):'''
** Milk Withdrawal: Milk from treated cows must not be used for human consumption for a specific period post-calving (often 96 hours post-calving if the dry period was of sufficient length).
** Meat Withdrawal: Animals must not be slaughtered for human consumption during treatment or for a specified period (e.g., 21 days) after the last treatment.


==Pediatric Dosing==
== Contraindications ==
===General (<7 Days)===
* Known hypersensitivity to Cephalosporins.
*40mg/kg/day IM/IV divided q12h
* History of anaphylaxis to Penicillins (Risk of cross-reactivity).
*First Dose: 20mg/kg IM/IV x 1
* '''Veterinary:''' Do not use in lactating cows; intended for use during the dry period only.
*Max 6g/day


===General (>7 Days - 1 Month)===
== Adverse Reactions ==
*<2000g
=== Serious ===
**40mg/kg/day IM/IV divided q12h
* Anaphylactic reactions (rare in animals).
**First Dose: 20mg/kg IM/IV x 1
* Superinfection (fungal or resistant bacterial growth).
**Max 6g/day
*>2000g
**60mg/kg/day IM/IV divided q8h
**First Dose: 20mg/kg IM/IV x 1
**Max 6g/day


===General (>1 Month)===
=== Common ===
*25-100mg/kg/day IM/IV divided q6-8h
* Local irritation at the infusion site.
*First Dose: 20-33mg/kg IM/IV x 1
* Transient eye irritation (ophthalmic use).
*Max 6g/day


===Community Acquired [[Pneumonia]] (>3 Months)===
== Pharmacology ==
*150mg/kg/day IM/IV divided q8h x 10 days
* '''Mechanism of Action:''' Bactericidal; inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), causing defects in the cell wall and leading to cell lysis.
*First Dose: 50mg/kg IM/IV x 1
* '''Absorption:'''
*May switch to PO regimen when able
** ''Intramammary:'' Formulated for slow release to persist in the udder for prolonged periods (weeks) during the dry period. Systemic absorption is minimal.
** ''Ophthalmic:'' Penetrates the cornea efficiently.
* '''Chemical Class:''' Synthetic organic compound; contains Isonicotinamides, Thiophenes, and Pyridinium structures.


==Special Populations==
== Antibiotic Sensitivities ==
*Pregnancy: B
* ''Note: As a 1st Generation Cephalosporin, the spectrum is primarily Gram-positive with modest Gram-negative coverage.''
*Lactation: Safe
*Renal
**Adult
***CrCl 35-54: give q8
***CrCl 11-34: give usual dose x1, then decrease dose 50% and give q12h
***CrCl <10: give usual dose x1, then decrease dose 50% and give q18-24h
***Hemodialysis: give 0.5-1g supplement
***Peritoneal dialysis: 500mg q12h
**Pediatric
***CrCl 40-70: give usual dose x 1, then decrease daily dose 40% and give q12h
***CrCl 20-39: give usual dose x 1, then decrease daily dose 75% and give q12h
***CrCl 5-19: give usual dose x 1, the decerase daily dose 90% and give q24h
***CrCl <5: not defined
***Hemodialysis: give supplement
***Peritoneal dialysis: no supplement
*Hepatic (Adult & Pediatric)
**Not defined
 
==Contraindications==
*Allergy to class/drug
 
==Adverse Reactions==
===Serious===
*Neutropenia
*[[Thrombocytopenia]]
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*Nephrotoxicity
*[[Seizures]]
*[[Clostridium difficile]]
 
===Common===
*[[Diarrhea]]
*[[Rash]]
*[[Nausea and Vomiting]]
*[[Abdominal Pain]]
*Anorexia
*Transaminitis
*Urticaria
*Thrombophlebitis
 
==Pharmacology==
*Half-life: 1.8h (3.7 ESRD)
*Metabolism: minimally metabolized in liver; CYP450
*Excretion: Urine
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
! Group !! Organism !! Sensitivity
| 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]]||X1
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
| ||[[N. meningitidis]]||R
|-
| ||[[Moraxella catarrhalis]]||I
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
|-
| ||[[Klebsiella]] sp||'''S'''
| rowspan="8" | '''Gram Positive'''
| Streptococcus agalactiae || '''S'''
|-
|-
| ||E. coli/Klebsiella ESBL+||R
| Streptococcus dysgalactiae || '''S'''
|-
|-
| ||E coli/Klebsiella KPC+||R
| Streptococcus uberis || '''S'''
|-
|-
| ||[[Enterobacter]] sp, AmpC neg||R
| Streptococcus pyogenes || '''S'''
|-
|-
| ||[[Enterobacter]] sp, AmpC pos||R
| Enterococcus spp. || R
|-
|-
| ||[[Serratia]] sp||R
| Staphylococcus aureus (MSSA) || '''S'''
|-
|-
| ||Serratia marcescens||X1
| MRSA || R
|-
|-
| ||[[Salmonella]] sp||X1
| Corynebacterium pyogenes || '''S'''
|-
|-
| ||[[Shigella]] sp||X1
| rowspan="8" | '''Gram Negatives'''
| Escherichia coli || '''S'''/I
|-
|-
| ||[[Proteus mirabilis]]||'''S'''
| Klebsiella spp. || '''S'''
|-
|-
| ||[[Proteus vulgaris]]||R
| Proteus mirabilis || '''S'''
|-
|-
| ||[[Providencia sp.]]||R
| Enterobacter spp. || R
|-
|-
| ||[[Morganella sp.]]||R
| Pseudomonas aeruginosa || R
|-
|-
| ||[[Citrobacter freundii]]||R
| Pasteurella multocida || '''S'''
|-
|-
| ||[[Citrobacter diversus]]||R
| Fusobacterium necrophorum || '''S'''
|-
|-
| ||[[Citrobacter sp.]]||R
| Haemophilus influenzae || R
|-
| ||[[Aeromonas sp]]||R
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||R
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||X1
|-
| ||[[Mycoplasm pneumoniae]]||X1
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||X1
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||X1
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||X1
|}
|}
'''Key:''' '''S''' = Susceptible, '''I''' = Intermediate, '''R''' = Resistant.


===Key===
== References ==
{{Template:Antibacterial Spectra Key}}
* [https://guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=13609 IUPHAR/BPS Guide to PHARMACOLOGY: Cefalonium]
 
* [https://en.wikipedia.org/wiki/Cefalonium Wikipedia: Cefalonium]
==See Also==
* [https://fpnotebook.com/ID/Pharm/FrstGnrtnCphlsprn.htm FP Notebook: First Generation Cephalosporins]
*[[Antibiotics (Main)]]
 
==References==
<references/>
*Epocrates


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

Revision as of 17:16, 27 January 2026

General

  • Type: 1st generation Cephalosporin
  • Dosage Forms: Intramammary suspension, Ophthalmic ointment
  • Routes of Administration: Intramammary (IMM), Topical (Ophthalmic)
  • Common Trade Names: Cepravin
  • Note: Cefalonium is a semi-synthetic cephalosporin used almost exclusively in **veterinary medicine**. It is widely used for "Dry Cow" therapy to treat and prevent mastitis. It is not approved for human use in most jurisdictions.

Adult Dosing

General

  • Human Systemic Dosing: Not established. Not indicated for human use.
  • Veterinary (Bovine) - Dry Cow Therapy:
    • Infuse one syringe (250 mg) into the teat canal of each quarter immediately after the last milking of the lactation.
    • Massage udder upwards to distribute the suspension.

Ophthalmic (Veterinary)

  • Apply a small amount (~1 cm) of ointment to the conjunctival sac q8–12h or as directed for infectious keratoconjunctivitis.

Pediatric Dosing

  • Safety and Efficacy: Not applicable (Veterinary drug).

Special Populations

  • Pregnancy/Lactation (Humans): No data available.
  • Veterinary Lactation (Withdrawal Periods):
    • Milk Withdrawal: Milk from treated cows must not be used for human consumption for a specific period post-calving (often 96 hours post-calving if the dry period was of sufficient length).
    • Meat Withdrawal: Animals must not be slaughtered for human consumption during treatment or for a specified period (e.g., 21 days) after the last treatment.

Contraindications

  • Known hypersensitivity to Cephalosporins.
  • History of anaphylaxis to Penicillins (Risk of cross-reactivity).
  • Veterinary: Do not use in lactating cows; intended for use during the dry period only.

Adverse Reactions

Serious

  • Anaphylactic reactions (rare in animals).
  • Superinfection (fungal or resistant bacterial growth).

Common

  • Local irritation at the infusion site.
  • Transient eye irritation (ophthalmic use).

Pharmacology

  • Mechanism of Action: Bactericidal; inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), causing defects in the cell wall and leading to cell lysis.
  • Absorption:
    • Intramammary: Formulated for slow release to persist in the udder for prolonged periods (weeks) during the dry period. Systemic absorption is minimal.
    • Ophthalmic: Penetrates the cornea efficiently.
  • Chemical Class: Synthetic organic compound; contains Isonicotinamides, Thiophenes, and Pyridinium structures.

Antibiotic Sensitivities

  • Note: As a 1st Generation Cephalosporin, the spectrum is primarily Gram-positive with modest Gram-negative coverage.
Group Organism Sensitivity
Gram Positive Streptococcus agalactiae S
Streptococcus dysgalactiae S
Streptococcus uberis S
Streptococcus pyogenes S
Enterococcus spp. R
Staphylococcus aureus (MSSA) S
MRSA R
Corynebacterium pyogenes S
Gram Negatives Escherichia coli S/I
Klebsiella spp. S
Proteus mirabilis S
Enterobacter spp. R
Pseudomonas aeruginosa R
Pasteurella multocida S
Fusobacterium necrophorum S
Haemophilus influenzae R

Key: S = Susceptible, I = Intermediate, R = Resistant.

References

Retrieved from "https://www.wikem.org/w/index.php?title=Cefazolin&oldid=385414"