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== General ==
==General==
* '''Type:''' [[Is Generation::1st generation]] [[Is DrugClass::Cephalosporin]]
*Type: [[Is Generation::1st generation]] [[Is DrugClass::Cephalosporin]]
* '''Dosage Forms:''' Intramammary suspension, Ophthalmic ointment
*Dosage Forms: powder for injection
* '''Routes of Administration:''' Intramammary (IMM), Topical (Ophthalmic)
*Dosage Strengths: 500mg; 1, 2, 10, 20, 100, 300g
* '''Common Trade Names:''' Cepravin
*Routes of Administration: IV, IM
* '''Note:''' Cefalonium is a semi-synthetic cephalosporin used almost exclusively in **veterinary medicine**. It is widely used for "Dry Cow" therapy to treat and prevent mastitis. It is not approved for human use in most jurisdictions.
*Common Trade Names: Ancef


== Adult Dosing ==
==Adult Dosing==
=== General ===
===General===
* '''Human Systemic Dosing:''' Not established. Not indicated for human use.
*Mild: 250-500mg IM/IV 8h
* '''Veterinary (Bovine) - Dry Cow Therapy:'''
*Mod-Severe: 500-1000mg IM/IV q6-8h
** Infuse one syringe (250 mg) into the teat canal of each quarter immediately after the last milking of the lactation.
*Life Threatening: 1-1.5g IM/IV q6h
** Massage udder upwards to distribute the suspension.
*Max: 12g/day


=== Ophthalmic (Veterinary) ===
===[[UTI]], Uncomplicated===
* Apply a small amount (~1 cm) of ointment to the conjunctival sac q8–12h or as directed for infectious keratoconjunctivitis.
*1g IM/IV q12


== Pediatric Dosing ==
===Pneumococcal [[Pneumonia]]===
* '''Safety and Efficacy:''' Not applicable (Veterinary drug).
*500mg IM/IV q12


== Special Populations ==
===[[Endocarditis]] Prophylaxis, Dental===
* '''Pregnancy/Lactation (Humans):''' No data available.
*1g IM/IV x1 (30-60 min before procedure)
* '''Veterinary Lactation (Withdrawal Periods):'''
** Milk Withdrawal: Milk from treated cows must not be used for human consumption for a specific period post-calving (often 96 hours post-calving if the dry period was of sufficient length).
** Meat Withdrawal: Animals must not be slaughtered for human consumption during treatment or for a specified period (e.g., 21 days) after the last treatment.


== Contraindications ==
==Pediatric Dosing==
* Known hypersensitivity to Cephalosporins.
===General (<7 Days)===
* History of anaphylaxis to Penicillins (Risk of cross-reactivity).
*40mg/kg/day IM/IV divided q12h
* '''Veterinary:''' Do not use in lactating cows; intended for use during the dry period only.
*First Dose: 20mg/kg IM/IV x 1
*Max 6g/day


== Adverse Reactions ==
===General (>7 Days - 1 Month)===
=== Serious ===
*<2000g
* Anaphylactic reactions (rare in animals).
**40mg/kg/day IM/IV divided q12h
* Superinfection (fungal or resistant bacterial growth).
**First Dose: 20mg/kg IM/IV x 1
**Max 6g/day
*>2000g
**60mg/kg/day IM/IV divided q8h
**First Dose: 20mg/kg IM/IV x 1
**Max 6g/day


=== Common ===
===General (>1 Month)===
* Local irritation at the infusion site.
*25-100mg/kg/day IM/IV divided q6-8h
* Transient eye irritation (ophthalmic use).
*First Dose: 20-33mg/kg IM/IV x 1
*Max 6g/day


== Pharmacology ==
===Community Acquired [[Pneumonia]] (>3 Months)===
* '''Mechanism of Action:''' Bactericidal; inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), causing defects in the cell wall and leading to cell lysis.
*150mg/kg/day IM/IV divided q8h x 10 days
* '''Absorption:'''
*First Dose: 50mg/kg IM/IV x 1
** ''Intramammary:'' Formulated for slow release to persist in the udder for prolonged periods (weeks) during the dry period. Systemic absorption is minimal.
*May switch to PO regimen when able
** ''Ophthalmic:'' Penetrates the cornea efficiently.
* '''Chemical Class:''' Synthetic organic compound; contains Isonicotinamides, Thiophenes, and Pyridinium structures.


== Antibiotic Sensitivities ==
==Special Populations==
* ''Note: As a 1st Generation Cephalosporin, the spectrum is primarily Gram-positive with modest Gram-negative coverage.''
*Pregnancy: B
*Lactation: Safe
*Renal
**Adult
***CrCl 35-54: give q8
***CrCl 11-34: give usual dose x1, then decrease dose 50% and give q12h
***CrCl <10: give usual dose x1, then decrease dose 50% and give q18-24h
***Hemodialysis: give 0.5-1g supplement
***Peritoneal dialysis: 500mg q12h
**Pediatric
***CrCl 40-70: give usual dose x 1, then decrease daily dose 40% and give q12h
***CrCl 20-39: give usual dose x 1, then decrease daily dose 75% and give q12h
***CrCl 5-19: give usual dose x 1, the decerase daily dose 90% and give q24h
***CrCl <5: not defined
***Hemodialysis: give supplement
***Peritoneal dialysis: no supplement
*Hepatic (Adult & Pediatric)
**Not defined
 
==Contraindications==
*Allergy to class/drug
 
==Adverse Reactions==
===Serious===
*Neutropenia
*[[Thrombocytopenia]]
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*Nephrotoxicity
*[[Seizures]]
*[[Clostridium difficile]]
 
===Common===
*[[Diarrhea]]
*[[Rash]]
*[[Nausea and Vomiting]]
*[[Abdominal Pain]]
*Anorexia
*Transaminitis
*Urticaria
*Thrombophlebitis
 
==Pharmacology==
*Half-life: 1.8h (3.7 ESRD)
*Metabolism: minimally metabolized in liver; CYP450
*Excretion: Urine
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
{| class="wikitable"
! Group !! Organism !! Sensitivity
| 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]]||X1
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
| ||[[N. meningitidis]]||R
|-
| ||[[Moraxella catarrhalis]]||I
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
|-
| rowspan="8" | '''Gram Positive'''
| ||[[Klebsiella]] sp||'''S'''
| Streptococcus agalactiae || '''S'''
|-
|-
| Streptococcus dysgalactiae || '''S'''
| ||E. coli/Klebsiella ESBL+||R
|-
|-
| Streptococcus uberis || '''S'''
| ||E coli/Klebsiella KPC+||R
|-
|-
| Streptococcus pyogenes || '''S'''
| ||[[Enterobacter]] sp, AmpC neg||R
|-
|-
| Enterococcus spp. || R
| ||[[Enterobacter]] sp, AmpC pos||R
|-
|-
| Staphylococcus aureus (MSSA) || '''S'''
| ||[[Serratia]] sp||R
|-
|-
| MRSA || R
| ||Serratia marcescens||X1
|-
|-
| Corynebacterium pyogenes || '''S'''
| ||[[Salmonella]] sp||X1
|-
|-
| rowspan="8" | '''Gram Negatives'''
| ||[[Shigella]] sp||X1
| Escherichia coli || '''S'''/I
|-
|-
| Klebsiella spp. || '''S'''
| ||[[Proteus mirabilis]]||'''S'''
|-
|-
| Proteus mirabilis || '''S'''
| ||[[Proteus vulgaris]]||R
|-
|-
| Enterobacter spp. || R
| ||[[Providencia sp.]]||R
|-
|-
| Pseudomonas aeruginosa || R
| ||[[Morganella sp.]]||R
|-
|-
| Pasteurella multocida || '''S'''
| ||[[Citrobacter freundii]]||R
|-
|-
| Fusobacterium necrophorum || '''S'''
| ||[[Citrobacter diversus]]||R
|-
|-
| Haemophilus influenzae || R
| ||[[Citrobacter sp.]]||R
|-
| ||[[Aeromonas sp]]||R
|-
| ||[[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]]||R
|-
| ||[[Prevotella melaninogenica]]||X1
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||X1
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||X1
|}
|}
'''Key:''' '''S''' = Susceptible, '''I''' = Intermediate, '''R''' = Resistant.


== References ==
===Key===
* [https://guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=13609 IUPHAR/BPS Guide to PHARMACOLOGY: Cefalonium]
{{Template:Antibacterial Spectra Key}}
* [https://en.wikipedia.org/wiki/Cefalonium Wikipedia: Cefalonium]
 
* [https://fpnotebook.com/ID/Pharm/FrstGnrtnCphlsprn.htm FP Notebook: First Generation Cephalosporins]
==See Also==
*[[Antibiotics (Main)]]
 
==References==
<references/>
*Epocrates


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

Latest revision as of 17:16, 27 January 2026

General

  • Type: 1st generation Cephalosporin
  • Dosage Forms: powder for injection
  • Dosage Strengths: 500mg; 1, 2, 10, 20, 100, 300g
  • Routes of Administration: IV, IM
  • Common Trade Names: Ancef

Adult Dosing

General

  • Mild: 250-500mg IM/IV 8h
  • Mod-Severe: 500-1000mg IM/IV q6-8h
  • Life Threatening: 1-1.5g IM/IV q6h
  • Max: 12g/day

UTI, Uncomplicated

  • 1g IM/IV q12

Pneumococcal Pneumonia

  • 500mg IM/IV q12

Endocarditis Prophylaxis, Dental

  • 1g IM/IV x1 (30-60 min before procedure)

Pediatric Dosing

General (<7 Days)

  • 40mg/kg/day IM/IV divided q12h
  • First Dose: 20mg/kg IM/IV x 1
  • Max 6g/day

General (>7 Days - 1 Month)

  • <2000g
    • 40mg/kg/day IM/IV divided q12h
    • First Dose: 20mg/kg IM/IV x 1
    • Max 6g/day
  • >2000g
    • 60mg/kg/day IM/IV divided q8h
    • First Dose: 20mg/kg IM/IV x 1
    • Max 6g/day

General (>1 Month)

  • 25-100mg/kg/day IM/IV divided q6-8h
  • First Dose: 20-33mg/kg IM/IV x 1
  • Max 6g/day

Community Acquired Pneumonia (>3 Months)

  • 150mg/kg/day IM/IV divided q8h x 10 days
  • First Dose: 50mg/kg IM/IV x 1
  • May switch to PO regimen when able

Special Populations

  • Pregnancy: B
  • Lactation: Safe
  • Renal
    • Adult
      • CrCl 35-54: give q8
      • CrCl 11-34: give usual dose x1, then decrease dose 50% and give q12h
      • CrCl <10: give usual dose x1, then decrease dose 50% and give q18-24h
      • Hemodialysis: give 0.5-1g supplement
      • Peritoneal dialysis: 500mg q12h
    • Pediatric
      • CrCl 40-70: give usual dose x 1, then decrease daily dose 40% and give q12h
      • CrCl 20-39: give usual dose x 1, then decrease daily dose 75% and give q12h
      • CrCl 5-19: give usual dose x 1, the decerase daily dose 90% and give q24h
      • CrCl <5: not defined
      • Hemodialysis: give supplement
      • Peritoneal dialysis: no supplement
  • Hepatic (Adult & Pediatric)
    • Not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 1.8h (3.7 ESRD)
  • Metabolism: minimally metabolized in liver; CYP450
  • Excretion: Urine
  • Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities[1]

Group Organism 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 X1
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae S
N. meningitidis R
Moraxella catarrhalis I
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp R
Serratia marcescens X1
Salmonella sp X1
Shigella sp X1
Proteus mirabilis S
Proteus vulgaris R
Providencia sp. R
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus R
Citrobacter sp. R
Aeromonas sp R
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 R
Prevotella melaninogenica X1
Clostridium difficile X1
Clostridium (not difficile) X1
Fusobacterium necrophorum X1
Peptostreptococcus sp. X1

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
  • Epocrates
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