-
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.
