Ceftibuten

From WikEM
Jump to: navigation, search

General

  • Type: Third generation cephalosporin
  • Dosage Forms: capsule, oral suspension
  • Dosage Strengths: capsule: 400mg; oral suspension: 90mg/5mL, 180mg/5mL
  • Routes of Administration: PO
  • Common Trade Names: Cedax

Adult Dosing

Chronic bronchitis, acute exacerbation

  • 400mg PO qd x10 days

Otitis media, acute

  • 400mg PO qd x10 days

Pharyngitis/Tonsillitis, streptococcal

  • 400mg PO qd x10 days

Pediatric Dosing

Otitis media, acute

  • 6 mo - 11 yo, <45kg
    • 9 mg/kg PO qd x10 days
    • Max: 400 mg/day
  • 12+ yo, >45kg
    • 400mg PO qd x10 days

Pharyngitis/Tonsillitis, streptococcal

  • 6 mo - 11 yo, <45kg
    • 9 mg/kg PO qd x10 days
    • Max: 400 mg/day
  • 12+ yo, >45kg
    • 400mg PO qd x10 days

Pneumonia, Community-acquired

  • 6 mo - 11 yo, <45kg
    • 9 mg/kg PO qd x10 days
    • Max: 400 mg/day
  • 12+ yo, >45kg
    • 400mg PO qd x10 days

Special Populations

  • Renal Dosing
    • Adult
      • CrCl 30-49: 200mg qd
      • CrCl 5-29: 100mg qd
      • CrCl <5: Not defined
      • HD: 400mg after each dialysis
      • PD: No supplement
    • Pediatric
      • CrCl 30-49: 4.5 mg/kg qd, max 200mg/day
      • CrCl 5-29: 2.25 mg/kg qd, max 100mg/day
      • CrCl <5: Not defined
      • HD: 9mg/kg after each dialysis, max 400mg;day
      • PD: No supplement
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

Contraindications

  • Hypersensitivity to class/drug
  • Caution:
    • Hypersensitivity to PCN
    • Renal impairment
    • Concurrent nephrotoxic agent
    • Seizure disorder
    • Recent antibiotic-associated colitis

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 2-2.5 hr; 13.4 hr if CrCl 5-29
  • Metabolism: Other
  • Excretion: Urine 56%, Feces 39%
  • Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae I
Viridans strep R
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium X1
MSSA R
MRSA R
CA-MRSA R
Staph. Epidermidis R
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae I
N. meningitidis I
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 X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia S
Stenotrophomonas maltophilia R
Yersinia enterocolitica S
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/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

References

  1. Sanford Guide to Antimicrobial Therapy 2014