II. Mechanism
- Third Generation Cephalosporins are divided into two groups
- Third Generation Broad-Spectrum Cephalosporin (included on this page)
- Third Generation Anti-Pseudomonal Cephalosporin
- Spectrum of Activity of broad spectrum agents
- Gram Positive Cocci
- Less activity than First Generation Cephalosporins
- EKP Gram Negative Bacteria
- ESP Gram Negative Bacteria
- Better activity than First Generation Cephalosporins
- Better activity than Second Generation Cephalosporins
- No Pseudomonas activity
- Contrast with Third Generation Anti-Pseudomonal Cephalosporin
- Gram Positive Cocci
III. Medications: Oral agents
-
Cefixime (Suprax)
- Adult
- Standard: 400 mg PO divided qd to bid
- Gonorrhea: 400 mg PO for single dose
- Child: 8 mg/kg/day divided daily to twice daily
- Adult
-
Cefpodoxime (Vantin)
- Good activity Gram Positive organisms
- Covers Staphylococcus Aureus
- Covers Pneumococcus
- Adult: 100 to 400 mg orally twice daily
- Child
- Pharyngitis: 10 mg/kg/day divided twice daily
- Otitis Media: 10 mg/kg/day taken daily
- Good activity Gram Positive organisms
-
Cefdinir (Omnicef)
- Age >13 years, Adult: 300 mg orally twice daily or 600 mg orally once daily
- Child <13 years old: 14 mg/kg/day divided once to twice daily
- Other oral Third Generation Cephalosporins that are no longer available in the United States
- Cefditoren Pivoxil (Spectracef)
- Ceftibuten (Cedax)
IV. Medications: Parenteral agents
-
Cefotaxime (Claforan)
- Most Staphylococcus Aureus and Anaerobic activity
- Adult: 1 to 2 grams IM or IV every 6 to 8 hours
- Child
- Standard: 50-150 mg/kg/day IM or IV divided q4-6h
- Meningitis: 200 mg/kg/day IV divided q6-8h
- Maximum dose: 2 grams
-
Ceftriaxone (Rocephin)
- Least Staphylococcus and Anaerobic activity
- Dilute in Lidocaine 1% for Intramuscular Injection
- In adults, 2 gram dose is preferred in >100 kg or critically ill patients
- Adult
- Standard: 1-2 grams IM or IV every 24 hours
- Gonorrhea: 250 mg IM single dose
- Child
- Standard: 50-75 mg/kg/day IV divided every 12-24 hours
- Meningitis: 100 mg/kg/day IV divided every 12-24 hours (twice daily is preferred)
- Otitis Media: 50 mg/kg IM single dose (max: 1g)
- Maximum Dose: 2 grams (4 grams for Meningitis)
- Other parenteral Third Generation Cephalosporins that are no longer available in the United States
- Ceftizoxime (Cefizox)
- Moderate Staphylococcus Aureus and Anaerobic Activity
- Adult: 1 to 2 grams IV every 8 to 12 hours
- Child: 50 mg/kg/dose IV every 6 to 8 hours
- Ceftizoxime (Cefizox)
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Related Studies
| Definition (NCI) | A semisynthetic, broad-spectrum, beta-lactamase-resistant, third-generation cephalosporin with antibacterial activity. Ceftizoxime binds to and inactivates penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. PBPs are enzymes involved in the terminal stages of assembling the bacterial cell wall and in reshaping the cell wall during growth and division. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis. |
| Definition (MSH) | A semisynthetic cephalosporin antibiotic which can be administered intravenously or by suppository. The drug is highly resistant to a broad spectrum of beta-lactamases and is active against a wide range of both aerobic and anaerobic gram-positive and gram-negative organisms. It has few side effects and is reported to be safe and effective in aged patients and in patients with hematologic disorders. |
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | D015296 |
| SnomedCT | 372770006, 54577009 |
| LNC | LP15253-5, MTHU004181 |
| English | Ceftizoxime, 5-Thia-1-azabicyclo(4.2.0)oct-2-ene-2-carboxylic acid, 7-(((2-amino-4-thiazolyl)(methoxyimino)acetyl)amino)-8-oxo-, (6R-(6alpha,7beta(Z)))-, Ceftizoxime [Chemical/Ingredient], ceftizoxime, Ceftizoxime (product), Ceftizoxime (substance), CEFTIZOXIME |
| Swedish | Ceftizoxim |
| Czech | ceftizoxim, cefpodoxim proxetil |
| Finnish | Keftitsoksiimi |
| Russian | TSEFTIZOKSIM, ЦЕФТИЗОКСИМ |
| Japanese | セフチゾキシムナトリウム, セフチゾキシム |
| Croatian | CEFTIZOKSIM |
| Polish | Ceftyzoksym |
| Spanish | ceftizoxima (producto), ceftizoxima (sustancia), ceftizoxima, Ceftizoxima |
| French | Ceftizoxime |
| German | Ceftizoxim |
| Italian | Ceftizoxima |
| Portuguese | Ceftizoxima |
Ontology: Third generation cephalosporin (C0304320)
| Concepts | Organic Chemical (T109) , Antibiotic (T195) |
| SnomedCT | 372859005, 81252003 |
| English | CEPHALOSPORIN 3RD GENERATION, antibacterial cephalosporins third generation, third generation cephalosporins, third generation cephalosporins (medication), [AM117] CEPHALOSPORIN 3RD GENERATION, 3rd generation cephalosporins, cephalosporin third generation, cephalosporin generation third, cephalosporins generation third, third generation cephalosporin, Third-generation cephalosporins, Third generation cephalosporin, Third generation cephalosporin (product), Third generation cephalosporin (substance), Third generation cephalosporin, NOS, Cephalosporin Antibacterials, 3rd Generation |
| Spanish | cefalosporina de tercera generación (producto), cefalosporina de tercera generación (sustancia), cefalosporina de tercera generación |
