Cefacetrile

General

• Type: 1st generation Cephalosporin
• Dosage Forms: Powder for injection
• Dosage Strengths: 500mg, 1g
• Routes of Administration: IV, IM
• Common Trade Names: Celospor, Celtol, Cristacef

Adult Dosing

General

• Mild-Moderate: 500mg-1g IM/IV q6-8h
• Severe: 1-2g IM/IV q4-6h
• Max: 6g/day (up to 12g has been used in extreme cases historically, but 6g is standard limit)

Urinary Tract Infection (Uncomplicated)

• 500mg IM/IV q8h

Respiratory Tract Infections

• 1g IM/IV q6h

Surgical Prophylaxis

• 1g IM/IV x1 (30-60 min before procedure)
• May repeat q6h during prolonged surgery

Pediatric Dosing

General (> 1 Month)

• 30-50mg/kg/day IM/IV divided q6-8h
• Severe Infections: Up to 80-100mg/kg/day IM/IV divided q4-6h
• Max: 4g/day (or adult max depending on weight)

Neonates (< 1 Month)

• Data is limited for this specific agent compared to Cefazolin.
• General 1st Gen recommendation: 20mg/kg/day IM/IV divided q12h

Special Populations

• Pregnancy: B
• Lactation: Safe (Excreted in low concentrations)
• Renal
  • Adult
    • CrCl >50: Usual regimen
    • CrCl 30-50: Usual dose q8h
    • CrCl 10-29: Usual dose q12h
    • CrCl <10: Usual dose q24h
    • Hemodialysis: Moderately dialyzable; administer dose after dialysis
  • Pediatric
    • Specific tiered dosing not fully substantiated; follow adult interval extensions based on GFR.
• Hepatic
  • No dosage adjustment usually required (Renal excretion).

Contraindications

• Allergy to Cephalosporins
• History of anaphylactic reaction to Penicillins

Adverse Reactions

Serious

• Anaphylaxis
• Angioedema
• Neutropenia (rare, reversible)
• Thrombocytopenia
• Pseudomembranous colitis (C. difficile)
• Nephrotoxicity (historically higher risk than newer agents, especially if combined with aminoglycosides)
• Elevated BUN/Creatinine

Common

• Phlebitis at injection site
• Pain at IM injection site
• Rash/Pruritus
• Diarrhea
• Nausea
• Eosinophilia
• Transient elevation of liver enzymes (AST/ALT)

Pharmacology

• Half-life: 1.2 - 1.5h (increases significantly in renal impairment)
• Metabolism: Minimally metabolized; some deacetylation
• Excretion: Urine (mostly unchanged)
• Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities

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	I
	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	R
	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
Additional GN	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	S
	Bacteroides fragilis	R
	Prevotella melaninogenica	X1
	Clostridium difficile	X1
	Clostridium (not difficile)	I
	Fusobacterium necrophorum	X1
	Peptostreptococcus sp.	S

Note: Cefacetrile shares the typical spectrum of "1st Generation" cephalosporins. "S" indicates Sensitive, "R" indicates Resistant, "I" indicates Intermediate, and "X1" typically indicates no data or specific reference required in the source material template.

References

• Martindale: The Complete Drug Reference
• Kucers' The Use of Antibiotics
• Sanford Guide to Antimicrobial Therapy (Historical Class Data)