View source for Cefmetazole

==General==
*Type: [[Is Generation::2nd generation]] [[Is DrugClass::Cephalosporin]]
*Group: Cephamycin
*Dosage Forms: Powder for injection
*Dosage Strengths: 1g, 2g
*Routes of Administration: IV
*Common Trade Names: Zefazone

==Adult Dosing==
===General===
*Mild-Moderate: 2g IV q6-12h
*Severe: 2g IV q6h
*Max: 8g/day

===Surgical Prophylaxis===
*1-2g IV 30-90 min pre-op
*May repeat at 8 and 16 hours post-op

===Uncomplicated [[Gonorrhea]]===
*1g IM x1 with 1g oral [[Probenecid]]

==Pediatric Dosing==
===General===
*Safety and effectiveness in pediatric patients have not been established.

==Special Populations==
*Pregnancy: B
*Lactation: Excreted in trace amounts; use with caution
*Renal
**Adult
***CrCl 50-90: 1-2g q12h
***CrCl 30-49: 1-2g q16h
***CrCl 10-29: 1-2g q24h
***CrCl <10: 1-2g q48h
***Hemodialysis: Administer dose after dialysis
**Pediatric
***Not defined
*Hepatic
**No adjustment defined

==Contraindications==
*Allergy to class/drug
*History of cephalosporin-associated hemolytic anemia

==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*[[Clostridium difficile]]
*Hypoprothrombinemia (due to N-MTT side chain)
*Disulfiram-like reaction (with alcohol ingestion, due to N-MTT side chain)
*Hemolytic Anemia

===Common===
*[[Diarrhea]]
*[[Rash]]
*[[Nausea and Vomiting]]
*Injection site pain/phlebitis
*Elevated LFTs

==Pharmacology==
*Half-life: 1.2h (prolonged in renal failure)
*Metabolism: Minimally metabolized (15% is metabolized to open beta-lactam ring)
*Excretion: Urine (85% unchanged)
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis. As a cephamycin, it is more resistant to beta-lactamases (especially from anaerobes) than 1st generation cephalosporins.

==[[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+||I
|-
| ||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]]||'''S'''
|-
| ||[[Providencia sp.]]||R
|-
| ||[[Morganella sp.]]||R
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||I
|-
| ||[[Citrobacter sp.]]||I
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||X1
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||R
|-
| ||[[Mycobacterium avium]]||R
|-
| Anaerobes||[[Actinomyces]]||'''S'''
|-
| ||[[Bacteroides fragilis]]||'''S'''
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||R
|-
| ||[[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]]