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cephalothin (Keflin)
Tradename: Keflin. 1st generation cephalosporin.
Indications:
- treatment of bacterial infections due to susceptible organisms
- lower respiratory tract infection
- pneumonia
- urogenital infection
- skin or soft tissue infection
- infectious arthritis, osteomyelitis
- prophylaxis for perioperative infection
Dosage: 0.5-2 g IV/IM 4-6 hours.
Children: 100 mg/kg/day.
Pharmacokinetics:
1) 22-32% metabolized to desacetyl derivative (20% as active as parent compound)
2) desacetyl metabolite accumulates with parent compund in renal failure
Antimicrobial activity:
Gram positive
- Streptococcus
- Streptococcus group A
- Streptococcus group B
- Streptococcus group C
- Streptococcus group G
- Streptococcus pneumonia
- Streptococcus viridans, milleri
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis (+/-)
Gram negative
- Neisseria gonorrhoeae
- Moraxella catarrhalis
- Haemophilus influenzae
- Escherichia coli
- Klebsiella species
- Salmonella
- Shigella
- Proteus mirabilis
- Haemophilus ducreyi
Anaerobes
- Actinomyces
Adverse effects:
1) hypertensive reaction
-> fever, malaise, weakness, skin rash, eosinophilia
2) hypersentive intersititial nephritis
3) increased ALT
4) hematologic
-> abnormal platelet aggregration, thrombocytopenia, granulocytopenia, hemolytic anemia
5) diarrhea
Test interactions:
a) positive direct Coomb's test
b) may interfere with Jaffe reaction for creatinine determination
Laboratory:
1) specimen:
a) serum
b) keep specimen on ice-water
c) centrifuge at 4 degrees C
d) remove cells as soon as possible
e) freeze at -70 degrees C until assayed
2) methods: HPLC, MB
Interactions
drug interactions
drug adverse effects of cephalosporins
General
cephalosporin, 1st generation
Properties
MISC-INFO: elimination route KIDNEY
1/2life 0.5-1 HOURS
protein-binding 65%
elimination by hemodialysis +
peritoneal dialysis +
pregnancy-category B
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Sanford Guide to antimicrobial therapy 1997
- Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed.,
W.B. Saunders, 1995
- Deprecated Reference