Cephalothin Brand Name– Keflin
What is Cephalothin
NOTE: This drug is discontinued in the US.
Cephalothin sodium is a parenteral semisynthetic first-generation cephalosporin antibiotic.
Its spectrum includes gram-positive organisms; cephalothin provides limited gram-negative coverage or anaerobic coverage.
Cephalothin has been most commonly utilized for perioperative infection prophylaxis in clean, contaminated surgeries such as cholecystectomy, vaginal hysterectomy, cesarean section, and some cardiovascular, intraabdominal, or arthroplasty procedures.
Other indications for cephalothin have included the treatment of urinary tract infections, skin and skin structure infections, respiratory tract infections, and septicemia due to susceptible organisms.
Cephalothin is not recommended for meningitis due to its limited antimicrobial spectrum and the availability of other cephalosporins with greater penetration into the CSF (e.g., cefotaxime or ceftriaxone). Intraventricular or ventricular shunt administration of cephalothin has been used for the treatment of ventriculitis in children with hydroencephalus.
Cephalothin has a short half-life and requires frequent IM or IV dosing. The need for frequent dosing and the side effects related to cephalothin administration limit its use in infections that require long durations of therapy (e.g., endocarditis).
Use of IV cephalothin beyond 3 days is associated with a high incidence of thrombophlebitis; IM administration of cephalothin is painful and typically produces induration.
Cephalothin was approved by the FDA in 1964. While several manufacturers throughout the world still supply cephalothin in generic form; cephalothin products have been discontinued for use by former manufacturers in the US due to limited clinical usage.
Indications
- bacteremia
- bone and joint infections
- cellulitis
- endocarditis
- Escherichia coli
- Haemophilus influenzae (beta-lactamase negative)
- Klebsiella pneumoniae
- Klebsiella sp.
- lower respiratory tract infections
- peritonitis
- pneumonia
- Proteus mirabilis
- pyelonephritis
- Salmonella sp.
- Shigella sp.
- skin and skin structure infections
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Staphylococcus saprophyticus
- Staphylococcus sp.
- Streptococcus agalactiae (group B streptococci)
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
- Streptococcus sp.
- surgical infection prophylaxis
- urinary tract infection (UTI)
Side Effects
- abdominal pain
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- anorexia
- aplastic anemia
- arthralgia
- azotemia
- candidiasis
- chills
- colitis
- diarrhea
- dizziness
- dysgeusia
- dyspepsia
- eosinophilia
- erythema
- erythema multiforme
- exfoliative dermatitis
- fatigue
- fever
- headache
- hemolytic anemia
- hypoprothrombinemia
- hypotension
- injection site reaction
- interstitial nephritis
- irritability
- leukopenia
- maculopapular rash
- nausea
- neutropenia
- nightmares
- oliguria
- pancytopenia
- paranoia
- phlebitis
- pruritus
- pruritus ani
- pseudomembranous colitis
- renal tubular necrosis
- seizures
- serum sickness
- Stevens-Johnson syndrome
- superinfection
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vaginitis
- vertigo
- vomiting
- xerostomia
Monitoring Parameters
- serum creatinine/BUN
Contraindications
- antimicrobial resistance
- breast-feeding
- cephalosporin hypersensitivity
- coagulopathy
- colitis
- diarrhea
- geriatric
- GI disease
- hepatic disease
- infection
- inflammatory bowel disease
- penicillin hypersensitivity
- pregnancy
- pseudomembranous colitis
- renal disease
- renal failure
- renal impairment
- ulcerative colitis
- viral infection
- vitamin K deficiency
Interactions
- Loop diuretics
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Warfarin
