Cefprozil dosing

The comorbid conditions that can affect therapy and outcomes in patients with CAP include diabetes mellitus, COPD, congestive heart failure, and renal failure.27,28 If the patient has not received antibiotics in the past 3 months, then clarithromycin or azithromycin is the recommended first-line therapy by the IDSA. If the patient has received antibiotics in the last 3 months, then the IDSA recommends using either a respiratory fluoroquinolone alone or a combination of an oral P-lactam and an advanced macrolide/azalide (e.g., clarithromycin/azithromydn). The ATS recommends combination therapy or monotherapy with a respiratory fluoroquinolone for all patients with comorbidities. The p-lactam agents recommended include high-dose amoxicillin, high-dose amoxicillin-clavulanate, cefpodoxime, cefprozil, and cefuroxime. 

Other FDA-approved antibiotics for ABRS not included in the Sinus and Allergy Health Partnership or AAP guidelines cefaclor, cefprozil, cefixime, ciprofloxacin, erythromycin, loracarbef. cMaximum dose not to exceed adult dose. 

If treatment failure occurs with amoxicillin, an agent should be chosen with activity against /1-lactamase-producing H. influenzae and M. catar-rhalis as well as drug-resistant S. pneumoniae (such as high-dose amoxicil-lin-clavulanate (recommended), or, cefuroxime, cefdinir, cefpodoxime, cefprozil, or intramuscular ceftriaxone). 

Cephalosporins Have a nucleus that is similar to that of (3-lactams and similarly dismpt the synthesis of the peptidoglycan layer. This layer is important in maintaining cell wall integrity in gram-positive bacteria. Omnicef (Cefdinir) Cefzil (Cefprozil) Cephalexin (Keflex) Bioavailabihty is dose dependent is only about 16-21%. About 90% is excreted as the parent compound. It is well absorbed by the body and 90% of the dmg is excreted unchanged. 

Space drug doses evenly around the clock and continue cefprozil therapy for the full course of treatment... 

Cefaclor, cefuroxime axetil, cefprozil, and loracarbef can be given orally. The usual dosage for adults is 10-15 mg/kg/d in two to four divided doses children should be given 20-40 mg/kg/d up to a maximum of 1 g/d. Except for cefuroxime axetil, these drugs are not predictably active against penicillin-resistant pneumococci and should be used cautiously, if at all, to treat suspected or proved pneumococcal infections. Cefaclor is more susceptible to 13-lactamase hydrolysis compared with the other agents, and its usefulness is correspondingly diminished. 

Barbhaiya, R.H. Shukla, U.A. Gleason, C.R. Shyu, W.C. Wilber, R.B. Martin, R.R. Pittman, K.A. Phase I study of multiple-dose cefprozil and comparison with cefaclor. Antimicrob.Agents Chemother., 1990, 34, 1198-1203... 

A study in healthy subjects found thaL although food caused slight changes in the rate of absorption of a 1-g dose of cefprozil its pharmacokinetics (including total absorption) were not significantly affected."... 

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