Drug Cards: Cephalosporins

Cefadroxil (Duricef)

• Class: Cephalosporins
• Therapeutic use: Treats infections caused by susceptible microorganisms
• Contraindications: Allergy to cephalosporin antibiotics
• Therapeutic blood serum level: 0.8 µg/mL
• Adverse effects: Nausea, vomiting, diarrhea, hypersensitivity, superinfection, nephrotoxicity, headache, Stevens-Johnson syndrome, pseudomembranous colitis
• Usual dose: 1-2g/day orally in divided doses
• Nursing implications: Use cautiously in renal disease, hepatic impairment, bleeding disorders, pregnancy, or known penicillin allergy
• Patient teaching: Avoid alcohol during and after treatment (3 days) to prevent severe reactions

Cefazolin Sodium (Ancef, Kefzol)

• Class: Cephalosporins
• Therapeutic use: Infections and perioperative prophylaxis
• Contraindications: Serious kidney problems, severe antibiotic-associated diarrhea, decreased prothrombin, blood clotting disorders
• Therapeutic blood serum level: 10-30 mcg/mL
• Adverse effects: Similar to cefadroxil
• Usual dose: 250 mg-1g IM/IV every 6-12 hours; perioperative: 0.5-1 g IM/IV
• Nursing implications: Adjust dosage in severe renal impairment; prolonged use may cause superinfection and antibiotic-associated colitis
• Patient teaching: Take medication at prescribed times; consider using with food or milk for better absorption

Cephalexin (Keflex, Biocef, Keftab)

• Class: Cephalosporins
• Therapeutic use: Similar to cefadroxil
• Contraindications: Allergy to cephalosporins
• Therapeutic blood serum level: 50-200 ng/mL
• Adverse effects: Similar to cefadroxil
• Usual dose: 1-4 g/day orally in divided doses
• Nursing implications: Use cautiously in hypersensitivity cases, pregnancy, lactation, and renal disease
• Patient teaching: Report symptoms of superinfection or allergy; notify healthcare professional of severe diarrhea, especially if bloody

Cephradine (Velosef)

• Class: Cephalosporins
• Therapeutic use: Similar to cefadroxil
• Contraindications: Serious kidney problems, severe antibiotic-associated diarrhea
• Therapeutic blood serum level: 8-42 mcg/mL
• Adverse effects: Similar to cefadroxil
• Usual dose: 250 mg-1g every 6-12 hours
• Nursing implications: Modify dosage in severe renal impairment; cautious use required in patients with penicillin allergy history
• Patient teaching: Advise on yogurt or buttermilk for diarrhea; report severe diarrhea, unusual symptoms, and consult on breastfeeding risks

Cefaclor (Ceclor)

• Class: Cephalosporins
• Therapeutic use: Treats infections caused by susceptible microorganisms
• Contraindications: Allergy to cephalosporins or hypersensitivity history
• Therapeutic blood serum level: 0.16 mcg/mL
• Adverse effects: Nausea, vomiting, diarrhea, hypersensitivity, nephrotoxicity, headache, hematologic reactions
• Usual dose: 250 mg orally every 8 hours
• Nursing implications: Use cautiously with significantly impaired renal function; assess prior hypersensitivity history before prescribing