Cefaloglycin

General

• Type: 1st generation Cephalosporin
• Dosage Forms: Capsule
• Dosage Strengths: 250mg, 500mg
• Routes of Administration: Oral (PO)
• Common Trade Names: Kafocin (Discontinued in many markets), Kefoglycin
• Note: Historically significant but largely replaced by Cephalexin due to Cefaloglycin's poor absorption, low serum levels, and higher incidence of gastrointestinal side effects.

Adult Dosing

General

• Mild-Moderate Infection: 250mg PO q6h
• Severe Infection: 500mg PO q6h
• Max: 4g/day

Urinary Tract Infection

• Acute/Chronic: 250mg – 500mg PO q6h
• Note: Provides adequate concentrations in urine despite low serum levels.

Skin and Soft Tissue

• 500mg PO q6h

Pediatric Dosing

General

• Usual Dosage: 25–50 mg/kg/day PO divided q6h
• Severe Infections: may increase to effect, not to exceed adult maximums.
• Note: Not recommended for infants < 1 month.

Special Populations

• Pregnancy: B
• Lactation: Excreted in breast milk in low concentrations; use with caution.
• Renal
  • Adult
    • CrCl >50: Usual regimen
    • CrCl 10-50: Administer q12h
    • CrCl <10: Administer q24h
    • Hemodialysis: Moderately dialyzable; give dose after session.
• Hepatic
  • No specific adjustment defined; caution recommended.

Contraindications

• Hypersensitivity/Allergy to Cephalosporins
• History of immediate anaphylactic reaction to Penicillins

Adverse Reactions

Serious

• Anaphylaxis
• Angioedema
• Pseudomembranous colitis (C. difficile)
• Steven-Johnson Syndrome
• Neutropenia (rare)

Common

• Diarrhea (High frequency compared to other cephalosporins)
• Nausea/Vomiting
• Abdominal pain
• Rash/Urticaria
• Vaginitis / Moniliasis
• Dizziness
• Headache

Pharmacology

• Absorption: Absorbed from GI tract but produces relatively low serum levels compared to Cephalexin.
• Half-life: ~1.5 hours in normal renal function.
• Metabolism: partly deacetylated in the body to desacetylcephaloglycin (which is also active).
• Excretion: Urine (high concentrations).
• Mechanism of Action: Bactericidal; interferes with bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs).

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	I
	N. meningitidis	X1
	Moraxella catarrhalis	I
	H. influenzae	R
	E. coli	S
	Klebsiella sp	S
	E. coli/Klebsiella ESBL+	R
	E coli/Klebsiella KPC+	R
	Enterobacter sp, AmpC neg	R
	Enterobacter sp, AmpC pos	R
	Serratia sp	R
	Serratia marcescens	R
	Salmonella sp	I
	Shigella sp	I
	Proteus mirabilis	S
	Proteus vulgaris	R
	Providencia sp.	R
	Morganella sp.	R
	Citrobacter freundii	R
	Citrobacter diversus	I
	Citrobacter sp.	R
	Aeromonas sp	R
	Acinetobacter sp.	R
	Pseudomonas aeruginosa	R
	Burkholderia cepacia	R
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	R
Additional GN	Francisella tularensis	X1
	Brucella sp.	X1
	Legionella sp.	R
	Pasteurella multocida	I
	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	X1
	Clostridium difficile	X1
	Clostridium (not difficile)	I
	Fusobacterium necrophorum	X1
	Peptostreptococcus sp.	S

Note: As a first-generation cephalosporin, Cefaloglycin shares a resistance profile almost identical to Cephalexin. "S" indicates Sensitive, "R" indicates Resistant, "I" indicates Intermediate, and "X1" indicates no specific data/reference.

References

• Martindale: The Complete Drug Reference
• American Society of Health-System Pharmacists (AHFS Drug Information)
• FDA Approved Labeling (Reference ID: Kafocin)