View source for Cefminox

==General==
*Type: [[Is Generation::2nd generation]] [[Is DrugClass::Cephalosporin]] (Cephamycin)
*Dosage Forms: powder for injection
*Dosage Strengths: 500mg, 1g
*Routes of Administration: IV, IM
*Common Trade Names: Meicelin

==Adult Dosing==
===General===
*Mild-Moderate: 1g IM/IV q12h
*Severe: 2-3g IM/IV divided q8-12h
*Life Threatening ([[Sepsis]], [[Peritonitis]]): Up to 6g/day IM/IV divided q6-8h
*Max: 6g/day

===[[UTI]], Complicated/Uncomplicated===
*1g IM/IV q12h

===Intra-abdominal Infections ([[Peritonitis]], [[Cholecystitis]])===
*2g IM/IV q12h or 1g q8h

===Respiratory Tract Infections===
*1g IM/IV q12h

==Pediatric Dosing==
===General===
*Mild-Moderate: 40-80mg/kg/day IM/IV divided q6-8h
*Severe/Sepsis: Up to 160mg/kg/day IM/IV divided q6-8h
*Max: 6g/day (should not exceed adult dose)

==Special Populations==
*Pregnancy: B
*Lactation: Excreted in breast milk; use with caution
*Renal
**Adult
***CrCl 30-60: give usual dose q12-24h
***CrCl 10-29: give usual dose q24h
***CrCl <10: give usual dose q24-48h
***Hemodialysis: Give dose after dialysis
***Peritoneal dialysis: Supplement not usually required
**Pediatric
***Renal dosing not well defined; adjust based on adult ratios
*Hepatic
**Monitor coagulation parameters (PT/INR) due to risk of hypoprothrombinemia

==Contraindications==
*Allergy to class/drug (Cephalosporins, Cephamycins)
*History of anaphylaxis to Penicillins
*Concurrent alcohol ingestion (Disulfiram-like reaction)

==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*Hypoprothrombinemia (Bleeding risk - due to NMTT side chain)
*[[Disulfiram]]-like reaction (with alcohol)
*[[Neutropenia]]
*[[Thrombocytopenia]]
*[[Clostridium difficile]] associated diarrhea
*[[Seizures]] (high doses in renal failure)

===Common===
*[[Diarrhea]]
*[[Rash]]
*[[Nausea and Vomiting]]
*[[Abdominal Pain]]
*Phlebitis at injection site
*Transaminitis

==Pharmacology==
*Half-life: ~2.5h (Prolonged in renal impairment)
*Metabolism: Not significantly metabolized (Excreted unchanged)
*Excretion: Urine (~90%)
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis; binds to PBPs

==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||'''S'''
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||X1
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||I
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||I
|-
| ||Serratia marcescens||R
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||R
|-
| ||[[Morganella sp.]]||R
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||I
|-
| ||[[Citrobacter sp.]]||I
|-
| ||[[Aeromonas sp]]||I
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||R
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||X1
|-
| ||[[Mycoplasm pneumoniae]]||X1
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||'''S'''
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}

===Key===
{{Template:Antibacterial Spectra Key}}

==See Also==
*[[Antibiotics (Main)]]

==References==
<references/>

[[Category:Pharmacology]] [[Category:ID]]