Cephalothin

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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

  1. bacteremia
  2. bone and joint infections
  3. cellulitis
  4. endocarditis
  5. Escherichia coli
  6. Haemophilus influenzae (beta-lactamase negative)
  7. Klebsiella pneumoniae
  8. Klebsiella sp.
  9. lower respiratory tract infections
  10. peritonitis
  11. pneumonia
  12. Proteus mirabilis
  13. pyelonephritis
  14. Salmonella sp.
  15. Shigella sp.
  16. skin and skin structure infections
  17. Staphylococcus aureus (MSSA)
  18. Staphylococcus epidermidis
  19. Staphylococcus saprophyticus
  20. Staphylococcus sp.
  21. Streptococcus agalactiae (group B streptococci)
  22. Streptococcus pneumoniae
  23. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  24. Streptococcus sp.
  25. surgical infection prophylaxis
  26. urinary tract infection (UTI)

Side Effects

  1. abdominal pain
  2. anaphylactic shock
  3. anaphylactoid reactions
  4. angioedema
  5. anorexia
  6. aplastic anemia
  7. arthralgia
  8. azotemia
  9. candidiasis
  10. chills
  11. colitis
  12. diarrhea
  13. dizziness
  14. dysgeusia
  15. dyspepsia
  16. eosinophilia
  17. erythema
  18. erythema multiforme
  19. exfoliative dermatitis
  20. fatigue
  21. fever
  22. headache
  23. hemolytic anemia
  24. hypoprothrombinemia
  25. hypotension
  26. injection site reaction
  27. interstitial nephritis
  28. irritability
  29. leukopenia
  30. maculopapular rash
  31. nausea
  32. neutropenia
  33. nightmares
  34. oliguria
  35. pancytopenia
  36. paranoia
  37. phlebitis
  38. pruritus
  39. pruritus ani
  40. pseudomembranous colitis
  41. renal tubular necrosis
  42. seizures
  43. serum sickness
  44. Stevens-Johnson syndrome
  45. superinfection
  46. thrombocytopenia
  47. toxic epidermal necrolysis
  48. urticaria
  49. vaginitis
  50. vertigo
  51. vomiting
  52. 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

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