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Second Generation Broad-spectrum Cephalosporin

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Second Generation Broad-spectrum Cephalosporin, Second Generation Cephalosporin, Loracarbef, Lorabid, Cefaclor, Ceclor

  • Indications
  1. See Second Generation Broad-spectrum Cephalosporin
  2. Conditions
    1. Respiratory tract infections
    2. Community Acquired Pneumonia
    3. Urinary Tract Infection
    4. Skin and Soft Tissue Infection
    5. Otitis Media (second-line)
    6. Acute Sinusitis (second-line)
    7. Streptococcal Pharyngitis (second-line)
    8. No significant CSF penetration
      1. Cefuroxime as an exception does penetrate CSF, but less than Third Generation Cephalosporins
  3. Antibiotic Coverage Spectrum
    1. Gram Positive Cocci
    2. EKP Gram Negative Bacteria
    3. Gram Negative Coccobacilli
    4. No significant anaerobic coverage
  • Medications
  • Available in U.S.
  1. Cefprozil (Cefzil)
    1. Adult: 250 to 500 mg orally divided daily to twice daily
    2. Child
      1. Otitis Media: 15 mg/kg/dose orally twice daily
      2. Pharyngitis: 7.5 mg/kg/dose orally twice daily for 10 days
  2. Cefuroxime (Ceftin, Zinacef)
    1. Adult
      1. Parenteral: 750 to 1500 mg IM or IV every 8 hours
      2. Oral: 250 to 500 mg orally twice daily
    2. Child
      1. Parenteral: 50-100 mg/kg/day IV divided every 6-8 hours
      2. Oral: 20-30 mg/kg/day orally divided twice daily
        1. Reported to have unpleasant taste
    3. Directions
      1. Take with food
  • Medications
  • Discontinued in U.S. (or avoided)
  1. Loracarbef (Lorabid)
    1. Listed for historical reasons
    2. Discontinued in U.S. in 2006
    3. Adult: 200 to 400 mg orally twice daily
    4. Child
      1. Otitis Media: 30 mg/kg/day divided bid
      2. Other infections: 15 mg/kg/day divided bid
    5. Directions
      1. Take more than 1 hour before or 2 hours after food
  2. Cefaclor (Ceclor)
    1. Listed for historical reference only
    2. Risk of significant serum-sickness type reaction
    3. Adult: 250 to 500 mg orally three times daily
    4. Child: 20 to 30 mg/kg/day (maximum 1 g/day) orally divided three times daily