The Hip: Preservation, Replacement and Revision

Cephalothin/Keflin


- First Generation Ceph
- 1-2gm q4hr IV or 125mg/kg/4-6hr,t1/2=40min;Inject;
- Decrease dose with renal failure;
- 60-70 % of dose will be excreted in urine (w/ nl R F(x))
- Contra with cephalo allergy, caution with penicillin allergy;
- Good diffusion from blood into CSF only with inflammation;
    - Note: Ratio of CSF to BloodLevel (%): Normal Meninges: nil
       Inflammed Meninges: 13 (if protein >50mg%)
- w/ osteomyelitis
  Dose IV  time p admin.  Mean Ser conc (ug/ml)    Mean Bone conc (ug/gm)
   1 gm        60              11.9                     3.9
   25 mg/kg  < 50              52.2                     1.9
IM:40 mg/kg    w0              89 to 107                1.4

 Plasmid-encoded enzyme is TEM-1; SHV-1 is also frequent in Klebsiella pneumoniae, and PSE-1 is the most common variety on plasmids in
 P. aeruginosa;  These enzymes confer resistance to Ampicillin, carbenicillin, Ticarcillin, cephalothin, and cefamandole but not to broad-spectrum cephalosporins, monobactams (Aztreonam), or cephamycins (cefoxitin)


Cephalothin and cefamandole penetration into bone, synovial fluid, and wound drainage fluid.

The penetration characteristics of cefazolin, cephalothin, and cephradine into bone in patients undergoing total hip replacement.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, November 30, 2012 3:27 pm