CrCl > 50: 600 mg iv q 12 h.
CrCl 50-30: 400 mg 12 h.
CrCl 15-30: 300 mg ivq 12 h.
CrCl < 10: 200 mg q 12 h.
Hemodialysis: 200 mg q 12 h.
Important side effects
Direct Coombs test seroconversion. If anemia develops during or after therapy, do an evaluation for drug-induced hemolytic anemia. Eosinophilic pneumonia (PubMed).
Neutropenia and Agranulocytosis, especially long term, high dose with clindamycin (PubMed).
Important drug interactions
Rants and Screeds
Treatment of choice
What makes this class of cephlosporin unique is that it is active against MRSA. Given that all the current MRSA drugs stink on ice, it is good to have an anti-MRSA beta-lactam.
Anything you would use a third generation cephalosporin for.
Don't use for
Not active against β-lactamase–producing, AMP C –derepressed Enterobacteriaceae or most nonfermentative gram-negative rods, including P. aerugenosa. Enterococcus is sensitive in test tubes, but no clinical trials and cephlosporins have a long history of not working for enterococcus. Oh, yeah, anaerobes not so good either.
Fifth generation cephalosporin.