cefprozil

(sef pro' zil)

Cefzil

Pregnancy Category B

Drug classes
Antibiotic
Cephalosporin (second generation)

Therapeutic actions
Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death.

Indications
• Pharyngitis or tonsillitis caused by S. pyogenes
• Secondary bacterial infection of acute bronchitis and exacerbation of chronic
bronchitis caused by S. pneumoniae, H. influenzae, M. catarrhalis
• Dermatologic infections caused by S. aureus, S. pyogenes
• Otitis media caused by S. pneumoniae, H. influenzae, M. catarrhalis
• Acute sinusitis caused by S. pneumoniae, S. aureus, H. influenzae, M. catarrhalis

Contraindications and cautions

• Contraindicated with allergy to cephalosporins or penicillins.
• Use cautiously with renal failure, lactation, pregnancy.

Available forms
Tablets—250, 500 mg; powder for suspension—125, 250 mg/5 mL

Dosages
ADULTS
250–500 mg PO q 12–24 hr. Continue treatment for 10 days.
PEDIATRIC PATIENTS
6 mo–2 yr: 7.5–15 mg/kg PO q 12 hr for 10 days.
2–12 yr: 7.5–20 mg/kg PO q 12 hr; continue treatment for 10 days.
GERIATRIC PATIENTS OR PATIENTS WITH RENAL IMPAIRMENT
For creatinine clearance of 30–120 mL/min, use standard dose; for creatinine clearance
0–30 mL/min, use 50% of standard dose.

Pharmacokinetics
Route Peak Duration
PO 6–10 hr 24–28 hr

Metabolism: T1/2: 78 min

Distribution: Crosses the placenta, enters breast milk
Excretion: Renal, unchanged

Adverse effects
 • CNS: Headache, dizziness, lethargy, paresthesias
• GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence,
pseudomembranous colitis, liver toxicity
• GU: Nephrotoxicity
• Hematologic: Bone marrow depression
• Hypersensitivity: Ranging from rash to fever to anaphylaxis; serum sickness
reaction
• Other: Superinfections

Interactions
Drug-drug
• Increased nephrotoxicity with aminoglycosides
• Increased bleeding effects if taken with oral anticoagulants
Drug-lab test
• Possibility of false results on tests of urine glucose using Benedict's solution,
Fehling's solution, Clinitest tablets; urinary 17-ketosteroids; direct Coombs' test.

Nursing considerations
Assessment
• History: Penicillin or cephalosporin allergy, pregnancy or lactation, renal failure
• Physical: Kidney function, respiratory status, skin status, culture and sensitivity
tests of infected area

Interventions
• Culture infection before drug therapy.
• Give drug with food to decrease GI discomfort.
• Refrigerate suspension after reconstitution, and discard after 14 days.
• Discontinue if hypersensitivy reaction occurs.
• Give the patient yogurt or buttermilk in case of diarrhea.
• Arrange for oral vancomycin for serious colitis that fails to respond to
discontinuation

Teaching points
• Take this drug with food.
• Complete the full course of this drug, even if you feel better.
• This drug is prescribed for this particular infection; do not use it to self-treat any
other infection.
• These side effects may occur: Stomach upset, loss of appetite, nausea (take drug
with food); diarrhea; headache, dizziness.
• Report severe diarrhea with blood, pus, or mucus; rash or hives; difficulty
breathing; unusual tiredness, fatigue; unusual bleeding or bruising.

Adverse effects in Italic are most common; those in Bold are life-threatening.