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First Generation Cephalosporins

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First Generation Cephalosporins, Cefazolin, Cefadroxil, Duricef, Ancef

  • See Also
  1. Cephalosporin
  2. Cephalexin (Keflex)
  • Indications
  1. Effective alternative to Penicillins
  2. Covers Gram Positive Cocci
  3. Covers some Gram Negative Bacilli (least coverage of the Cephalosporins)
  4. Clinical Conditions
    1. Skin and Soft Tissue Infection
    2. Streptococcal Pharyngitis
    3. Simple Urinary Tract Infections (Acute Cystitis)
    4. Not indicated for Otitis Media (inadequate coverage due to resistance)
  • Mechanism
  • Activity Spectrum
  1. Good Gram Positive Cocci Coverage
    1. Streptococcus
    2. Staphylococcus
  2. Modest EKP Gram Negative Bacteria covered
    1. Escherichia coli
    2. Klebsiella
    3. Proteus
  • Contraindications
  • Relative
  1. MRSA
  2. Enterococcus
  3. Enterobacter
  4. Proteus Vulgaris
  5. Morganella marganii
  6. Pseudomonas
  7. Acinebacter calcoaceticus
  • Preparations
  • Oral
  1. Directions
    1. May take with or without food
  2. Cephalexin (Keflex)
    1. Adult: 250 to 500 mg orally 4 times daily
    2. Child: 25 to 50 mg/kg/day orally divided 4 times daily
  3. Cefadroxil (Duricef)
    1. Generic, and similar efficacy to Cephalexin, with the ease of twice daily dosing instead of four times daily
    2. Adult: 1 to 2 grams/day orally divided once to twice daily
    3. Child: 30 mg/kg/day orally divided twice daily
  • Preparations
  • Parenteral - Cefazolin (Ancef)
  1. Adult: 0.5 to 1.5 grams IM or IV every 6-8 hours
  2. Child
    1. Standard: 25 to 50 mg/kg/day divided q6-8 hours
    2. Severe Infection: 100 mg/kg/day divided q6-8 hours
    3. Maximum: 2 grams per dose
  • Resources
  1. Cephalexin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5681d4d2-9b67-4cac-9b94-8368f9978231