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65 Ceftizoxime 1.4-1. Intrapartum anti-infective prophylaxis for prevention of early-onset neonatal GBS disease is administered selectively to women at high risk for transmitting GBS infection to their neonates.When intrapartum prophylaxis is indicated in the mother, penicillin G (5 million units IV initially followed by 2.5 million units IV every 4 hours until delivery) is the regimen of choice and ampicillin (2 g IV initially followed by 1 g IV every 4 hours until delivery) is the preferred alternative.

Other causes of colitis should also be considered.Local reactions are quite common following IM or IV administration of some parenteral cephalosporins; phlebitis and thrombophlebitis occasionally occur with IV administration of the drugs. The mechanism(s) of the hypoprothrombinemic effect of these drugs has not been clearly established.While hypoprothrombinemia with some of the drugs may result in part from a reduction in vitamin K-producing bacteria in the GI tract, there is evidence that a direct effect on hepatic synthesis of prothrombin or prothrombin precursors is involved. Although routine use of vancomycin for perioperative prophylaxis is not recommended, vancomycin may be considered an alternative for perioperative prophylaxis in noncardiac thoracic surgery patients who are hypersensitive to β-lactam anti-infectives or at institutions where oxacillin-resistant S. aureus and S. epidermidis frequently cause wound infection.Perioperative prophylaxis generally is not indicated for patients undergoing routine gastroesophageal endoscopy, but some clinicians recommend such prophylaxis in patients undergoing placement of percutaneous gastrostomy and for high-risk patients undergoing esophageal dilation or sclerotherapy of varices. cefuroxime, cefaclor, cefadroxil). cefuroxime, cefaclor, cefadroxil).

For information regarding indications for prophylaxis against bacterial endocarditis, see Uses: Prevention of Bacterial Endocarditis, in the Aminopenicillins General Statement 8:12.16.08.Some parenteral third generation cephalosporins are used in the treatment of GI infections caused by Salmonella or Shigella or the treatment of other uncommon infectious diarrheal illnesses, including infections caused by Vibrio and Yersinia.Anti-infective therapy generally is not indicated in otherwise healthy individuals with uncomplicated (noninvasive) gastroenteritis caused by non-typhi Salmonella (e.g., S. enteritidis, S. typhimurium) since these infections generally subside spontaneously and there is some evidence that such therapy may prolong the duration of fecal excretion of the organisms; however, the CDC, AAP, IDSA, and others recommend anti-infective therapy in individuals with severe Salmonella gastroenteritis and in those who are at increased risk of invasive disease.These individuals at increased risk include infants younger than 3-6 months of age; individuals older than 50 years of age; individuals with hemoglobinopathies, severe atherosclerosis or valvular heart disease, prostheses, uremia, chronic GI disease, or severe colitis; and individuals who are immunocompromised because of malignancy, immunosuppressive therapy, HIV infection, or other immunosuppressive illness.However, no controlled studies have demonstrated a beneficial effect of such treatment and there is some evidence that anti-infective therapy can prolong the duration of fecal excretion of the organism. For specific dosages and additional information on chemistry and stability, spectrum, resistance, pharmacokinetics, uses, cautions, drug interactions, and laboratory test interferences of the cephalosporins, see the individual monographs in 8:12.06.Check your inbox or spam folder to confirm your subscription. Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Cefadroxil is an oral antibiotic in the cephalosporin family of drugs, a family that includes cephalexin (), cefaclor (Ceclor), cefuroxime (), cefpodoxime (), cefixime (), and many other injectable antibiotics.Cephalosporins stop bacteria from multiplying by preventing bacteria from forming the walls that surround them. Because some cephalosporins have been associated with a decrease in prothrombin activity, some manufacturers state that prothrombin time (PT) should be monitored when these drugs are used in patients with renal or hepatic impairment, in patients with poor nutritional status, in patients receiving a protracted course of anti-infective therapy, or in those previously stabilized on anticoagulant therapy.Although there have been no reports of adverse effects to the fetus to date, safe use of cephalosporins during pregnancy has not been definitely established. Based on experience in adults, the AAP states that use of oral cefixime can be considered for the treatment of uncomplicated gonorrhea in young children provided that follow-up can be assured.The CDC and many clinicians currently recommend that uncomplicated cervical, urethral, or rectal infections caused by penicillinase-producing N. gonorrhoeae (PPNG) or nonpenicillinase-producing N. gonorrhoeae in adults and adolescents be treated with a single IM dose of ceftriaxone, a single oral dose of cefixime, or a single oral dose of certain fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin) given in conjunction with an anti-infective regimen effective for presumptive treatment of chlamydia (e.g., a single dose of oral azithromycin or a 7-day regimen of oral doxycycline).However, fluoroquinolones should not be used for the treatment of gonorrhea acquired in Asia or the pacific islands (including Hawaii) and may be inadvisable for infections acquired in other areas where N. gonorrhoeae with quinolone resistance have been reported (including California).

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