Dosing and uses of Cefzil (cefprozil)
Adult dosage forms and strengths
tablet
- 250mg
- 500mg
oral suspension
- 125mg/5mL
- 250mg/5mL
Pharyngitis & Tonsillitis
Caused by S. Pyogenes
500 mg PO qDay for 10 days
Respiratory Tract Infections
250-500 mg PO q12hr for10 days
Skin Infections
250-500 mg q12hr OR 500 mg qDay for10 days
Renal Impairment
CrCl <30 mL/min: Give 1/2 usual dose
Other Indications & Uses
Spectrum similar to cefuroxime; used for respiratory tract infections & otitis media
B. fragilis, C. perfringens, E. coli, H. influenzae, Klebsiella spp., M. catarrhalis, S. aureus, S. pyogenes
Pediatric dosage forms and strengths
tablet
- 250mg
- 500mg
oral suspension
- 125mg/5mL
- 250mg/5mL
Acute Otitis Media
6 months old-12 years old: 30 mg/kg/day divided q12hr PO x 10 days
Acute Sinusitis
6 months old-12 years old: 15-30 mg/kg/day divided q12hr PO x10 days
Pharyngitis & Tonsillitis
2-12 years old: 15 mg/kg/day divided q12hr PO x10 days
Skin Infections
2-12 years old: 20 mg/kg PO qDay x10 days
>12 years
As in adults
Geriatric dosage forms and strengths
Pharyngitis & Tonsillitis
Caused by S. Pyogenes 500 mg PO qDay for 10 days
Respiratory Tract Infections
250-500 mg PO q12hr for10 days
Skin Infections
250-500 mg q12hr OR 500 mg qDay for10 days
Cefzil (cefprozil) adverse (side) effects
1-10%
Nausea (3.5%)
Diarrhea (2.9%)
Elevated LFTs (2%)
Diaper rash (1.5%)
Abdominal pain (1%)
Dizziness (1%)
Vomiting (1%)
eosinophilia
superinfection
vaginitis
<1%
Eosinophilia
Superinfection
Vaginitis
Cholestatic jaundice
Elevated BUN & creatinine
Prolonged Pt
Warnings
Contraindications
Documented hypersensitivity
Cautions (additional)
Phenylketonurics: Oral susp contains aspartame
Adjust dose in severe renal insufficiency (high doses may cause CNS toxicity); superinfections, and promotion of non-susceptible organisms may occur with prolonged use or repeated therapy; caution with history of GI disease, especially colitis
Pregnancy and lactation
Pregnancy category: B
Lactation: low distribution into breast milk; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Cefzil (cefprozil)
Half-Life: 1.3 hr
Peak Plasma Time: 1.5 hr
Protein Bound: 35-45%
Absorption: oral 94%
Metabolism: liver
Excretion: unchanged in urine: 61%
Mechanism of action
Second-generation cephalosporin that binds to one or more of the penicillin-binding proteins, which in turn inhibits cell wall synthesis and results in bactericidal activity. Has gram-positive activity that first-generation cephalosporins have and adds activity against P mirabilis, H influenzae, E coli, K pneumoniae, and M catarrhalis
