Second Generation Broad-spectrum Cephalosporins

Aka: Second Generation Broad-spectrum Cephalosporins, Second Generation Cephalosporins, Cefuroxime, Loracarbef, Cefprozil, Lorabid, Cefzil, Ceftin

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II. Coverage

  1. Gram Positive Cocci
  2. EKP Gram Negative Bacteria
  3. Gram Negative Coccobacilli

III. Indications

  1. Respiratory tract infections
  2. Acute Sinusitis
  3. Otitis Media

IV. Preparations

  1. Loracarbef (Lorabid)
    1. Adult: 200 to 400 mg po bid
    2. Child
      1. Otitis Media: 30 mg/kg/day divided bid
      2. Other infections: 15 mg/kg/day divided bid
    3. Directions
      1. Take more than 1 hour before or 2 hours after food
  2. Cefprozil (Cefzil)
    1. Adult: 250 to 500 mg PO divided qd to bid
    2. Child
      1. Otitis Media: 15 mg/kg/dose PO bid
      2. Pharyngitis: 7.5 mg/kg/dose PO bid for 10 days
  3. Cefuroxime (Ceftin, Zinacef)
    1. Adult
      1. Parenteral: 750 to 1500 mg IM or IV every 8 hours
      2. Oral: 250 to 500 mg PO bid
    2. Child
      1. Parenteral: 50-100 mg/kg/day IV divided q6-8 hours
      2. Oral: 20-30 mg/kg/day PO divided bid
        1. Reported to have unpleasant taste
    3. Directions
      1. Take with food
  4. Cefaclor (Ceclor)
    1. Listed for historical reference only
    2. Risk of significant serum-sickness type reaction

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Cost: Medications

cefuroxime (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CEFUROXIME AXETIL 250 MG TAB Generic $0.84 each
CEFUROXIME AXETIL 500 MG TAB Generic $1.26 each
cefprozil (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CEFPROZIL 125 MG/5 ML SUSP Generic $0.24 per ml
CEFPROZIL 250 MG TABLET Generic $1.01 each
CEFPROZIL 250 MG/5 ML SUSP Generic $0.45 per ml
CEFPROZIL 500 MG TABLET Generic $1.35 each
ceftin (on 1/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CEFTIN 125 MG/5 ML ORAL SUSP $1.43 per ml
CEFTIN 250 MG/5 ML ORAL SUSP $2.37 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Ontology: Cefuroxime (C0007562)

Definition (NCI) A semisynthetic, broad-spectrum, beta-lactamase-resistant, second-generation cephalosporin with antibacterial activity. Cefuroxime 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) Broad-spectrum cephalosporin antibiotic resistant to beta-lactamase. It has been proposed for infections with gram-negative and gram-positive organisms, GONORRHEA, and HAEMOPHILUS.
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH D002444
SnomedCT 372833007, 73986003
LNC LP32648-5, MTHU027952
English Cefuroxime, Cephuroxime, 5-Thia-1-azabicyclo(4.2.0)oct-2-ene-2-carboxylic acid, 3-(((aminocarbonyl)oxy)methyl)-7-((2-furanyl(methoxyimino)acetyl)amino)-8-oxo-, (6R-(6alpha,7beta(Z)))-, cefuroxime (medication), Cefuroxime [Chemical/Ingredient], CEFUROXIME, cephuroxime, cefuroxime, Cefuroxime (product), Cefuroxime (substance)
Swedish Cefuroxim
Czech cefuroxim
Finnish Kefuroksiimi
Russian TSEFUROKSIM, ЦЕФУРОКСИМ
Japanese セフロキシム
Croatian CEFUROKSIM
Polish Cefuroksym
Spanish cefuroxima (producto), cefuroxima (sustancia), cefuroxima, Cefuroxima
French Céfuroxime
German Cefuroxim
Italian Cefuroxima
Portuguese Cefuroxima
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: cefprozil (C0053882)

Definition (NCI) A semi-synthetic cephalosporin and a beta-lactam antibiotic with bactericidal activity. Cefprozil's effect is dependent on its binding to penicillin-binding proteins (PBPs) located in the bacterial cytoplasmic membrane. Binding results in the inhibition of the transpeptidase enzymes, thereby preventing cross-linking of the pentaglycine bridge with the fourth residue of the pentapeptide and interrupting consequent synthesis of peptidoglycan chains. As a result, cefprozil inhibits bacterial septum and cell wall synthesis formation.
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH C052018
SnomedCT 387538005, 96054007
LNC LP15219-6, MTHU001907
English cefprozil, CEFPROZIL, cefprozil (medication), 5-Thia-1-azabicyclo(4.2.0)oct-2-ene-2-carboxylic acid, 7-(((2R)-amino(4-hydroxyphenyl)acetyl)amino)-8-oxo-3-(1-propenyl)-, (6R,7R)-, cefprozil [Chemical/Ingredient], Cefprozil, Cefprozil (product), Cefprozil (substance)
Spanish cefprozilo (producto), cefprozilo, cefprozilo (sustancia), cefprozil, cefprozil (producto), cefprozil (sustancia)
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: loracarbef (C0065295)

Definition (NCI) A semi-synthetic, broad-spectrum, beta-lactamase resistant, second-generation cephalosporin antibiotic derived from cephasporium. The bactericidal activity of loracarbef results from the inhibition of bacterial cell wall synthesis through interference with the cross-linking of peptidoglycan units. This results in a reduction of cell wall stability and causes cell lysis. Loracarbef is more active against a variety of gram-negative organisms but less active against gram-positive pathogens compared to first-generation agents.
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH C054920
SnomedCT 96061006, 370362008
LNC LP15927-4, MTHU008099
English 1-Azabicyclo(4.2.0)oct-2-ene-2-carboxylic acid, 7-((aminophenylacetyl)amino)-3-chloro-8-oxo-, (6R-(6alpha,7beta(R*)))-, loracarbef, (6R, 7S)-7-[(R)-2-Amino-2-phenylacetamido]-3-chloro-8-oxo-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic Acid, Monohydrate, loracarbef (medication), loracarbef [Chemical/Ingredient], Carbacefaclor, Loracarbef, Loracarbef (substance), Loracarbef product (product), Loracarbef product, LORACARBEF
Spanish loracarbef, producto con loracarbef (producto), loracarbef (producto), producto con loracarbef, carbacefaclor (sustancia), carbacefaclor
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Ceftin (C0719197)

Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH C040738
English Ceftin, ceftin
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Lorabid (C0721422)

Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH C054920
English lorabid, Lilly Brand of Loracarbef Monohydrate, Monarch Brand of Loracarbef Monohydrate, Lorabid
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Cefzil (C0728743)

Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH C052018
English Cefzil, cefzil, Bristol-Myers Squibb brand of cefprozil
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Pharmacology

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