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Third Generation Broad-Spectrum Cephalosporins

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Third Generation Broad-Spectrum Cephalosporins, Third Generation Cephalosporins, Ceftriaxone, Ceftizoxime, Cefotaxime, Cefpodoxime, Cefixime, Claforan, Rocephin, Vantin, Cefdinir, Omnicef

  • See Also
  1. Third Generation Anti-Pseudomonal Cephalosporins
  2. Cephalosporin
  • Mechanism
  • Spectrum of Activity
  1. Gram Positive Cocci
    1. Less activity than First Generation Cephalosporins
  2. EKP Gram Negative Bacteria
  3. ESP Gram Negative Bacteria
    1. Better activity than First Generation Cephalosporins
    2. Better activity than Second Generation Cephalosporins
  4. No Pseudomonas activity
  • Preparations
  • Oral agents
  1. Cefixime (Suprax)
    1. Adult
      1. Standard: 400 mg PO divided qd to bid
      2. Gonorrhea: 400 mg PO for single dose
    2. Child: 8 mg/kg/day divided daily to twice daily
  2. Cefpodoxime (Vantin)
    1. Good activity Gram Positive organisms
      1. Covers Staphylococcus aureus
      2. Covers Pneumococcus
    2. Adult: 100 to 400 mg orally twice daily
    3. Child
      1. Pharyngitis: 10 mg/kg/day divided twice daily
      2. Otitis Media: 10 mg/kg/day taken daily
  3. Cefdinir (Omnicef)
    1. Age >13 years, Adult: 300 mg orally twice daily or 600 mg orally once daily
    2. Child <13 years old: 14 mg/kg/day divided once to twice daily
  • Preparations
  • Parenteral agents
  1. Cefotaxime (Claforan)
    1. Most Staphylococcus aureus and Anaerobic activity
    2. Adult: 1 to 2 grams IM or IV every 6 to 8 hours
    3. Child
      1. Standard: 50-150 mg/kg/day IM or IV divided q4-6h
      2. Meningitis: 200 mg/kg/day IV divided q6-8h
      3. Maximum dose: 2 grams
  2. Ceftizoxime (Cefizox)
    1. Moderate Staphylococcus aureus and Anaerobic Activity
    2. Adult: 1 to 2 grams IV every 8 to 12 hours
    3. Child: 50 mg/kg/dose IV every 6 to 8 hours
  3. Ceftriaxone (Rocephin)
    1. Least Staphylococcus and Anaerobic activity
    2. Dilute in Lidocaine 1% for Intramuscular Injection
    3. Adult
      1. Standard: 1-2 grams IM or IV every 24 hours
      2. Gonorrhea: 250 mg IM single dose
    4. Child
      1. Standard: 50-75 mg/kg/day IV divide q12-24 hours
      2. Meningitis: 100 mg/kg/day IV divided q12-24 hours
      3. Otitis Media: 50 mg/kg IM single dose (max: 1g)
      4. Maximum Dose: 2 grams (4 grams for Meningitis)