Pharmacologic: third-generation cephalosporins
Treatment of the following infections caused by susceptible organisms: Community-acquired pneumonia (adults only); Acute exacerbations of chronic bronchitis (adults only); Acute maxillary sinusitis (adults only); Pharyngitis and tonsillitis; Uncomplicated skin and skin structure infections; Acute bacterial otitis media (children only).
Binds to bacterial cell wall membrane, causing cell death. Therapeutic Effects: Bactericidal action against susceptible bacteria. Spectrum: Active against the following gram-positive organisms: Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes. Active against the following gram-negative organisms: Haemophilus influenzae (including β-lactamase–producing strains), Haemophilus parainfluenzae (including β-lactamase–producing strains), Moraxella catarrhalis (including β-lactamase–producing strains). Not active against methicillin-resistant staphylococci or enterococci.
Adverse Reactions/Side Effects
CNS: SEIZURES, headache. GI: PSEUDOMEMBRANOUS COLITIS, diarrhea, vomiting, abdominal pain, nausea. GU: vaginal moniliasis, vaginitis. Derm: rash, pruritus. Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Watch for seizures; notify physician immediately if patient develops or increases seizure activity.
Monitor signs of pseudomembranous colitis, including diarrhea, abdominal pain, fever, pus or mucus in stools, and other severe or prolonged GI problems (nausea, vomiting, heartburn). Notify physician or nursing staff immediately of these signs.
Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.
Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection. Use universal precautions or isolation procedures as indicated for specific patients.
Instruct patient and family/caregivers to report other troublesome side effects such as severe or prolonged headache, skin problems (rash, itching), vaginal inflammation or infection, or GI problems (nausea, vomiting, diarrhea, abdominal pain).
Absorption: 16–25% absorbed after oral administration.
Distribution: Widely distributed.
Metabolism and Excretion: Mostly excreted unchanged in urine.
Half-life: 1.7 hr (increased in renal impairment).
TIME/ACTION PROFILE (blood levels)
|ROUTE ||ONSET ||PEAK ||DURATION |
|PO ||rapid ||2–4 hr ||12–24 hr |
Contraindicated in: Hypersensitivity to cephalosporins; Serious hypersensitivity to penicillins.
Use Cautiously in: Renal impairment (dosage reduction recommended if CCr <30 mL/min); Diabetes (suspension contains sucrose); History of GI disease, especially colitis; Geriatric patients (dosage adjustment due to age-related decrease in renal function may be necessary); Pregnancy, lactation, or children <6 mo (safety not established).