cefamandole

J01DC03

Forms & Strengths

Adult Dosing

General infections: 500 mg to 1 g every 4 to 8 hours intramuscularly or intravenously
Severe infections: 1 g to 2 g every 4 to 6 hours
Surgical prophylaxis: 1 to 2 g IV 30-60 minutes before surgery, then 1 to 2 g every 6 hours for up to 24-48 hours

Pediatric Dosing

Neonates (over 1 week) and infants/children: 50 to 100 mg/kg/day divided into equally spaced doses every 4 to 8 hours
Severe infections: Up to 150 mg/kg/day (not to exceed maximum adult doses)

Indications

Treatment of respiratory tract infections caused by susceptible organisms
Urinary tract infections
Peritonitis, septicemia, skin and skin structure infections, bone and joint infections
Perioperative surgical prophylaxis

Mechanism of Action

Second-generation cephalosporin beta-lactam antibiotic
Inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs)
Bactericidal activity against a broad spectrum of gram-positive and gram-negative bacteria

Contraindications

Hypersensitivity to cefamandole, other cephalosporins, or penicillin class antibiotics
History of cephalosporin-associated jaundice or hepatic dysfunction

Adverse Reactions

Hypersensitivity reactions including anaphylaxis, urticaria, rash
Hematologic effects: hypoprothrombinemia, bleeding diathesis, positive direct Coombs' test, neutropenia
Gastrointestinal: pseudomembranous colitis, diarrhea, nausea, vomiting
Local reactions: thrombophlebitis at injection site, pain and induration with IM administration
Transient elevations in liver function tests and BUN/creatinine

Drug Interactions

Disulfiram-like reaction (flushing, nausea, vomiting, tachycardia) when co-administered with ethanol
Increased risk of bleeding when combined with anticoagulants, thrombolytic agents, or long-term NSAIDs due to N-methylthiotetrazole side chain causing hypoprothrombinemia
Antagonism of bactericidal activity possible with concurrent bacteriostatic antibiotics (e.g., tetracyclines, erythromycin)
Potential nephrotoxicity enhancement when used concomitantly with aminoglycosides or potent loop diuretics

Curated Content: Needs Vetting Before Put to Clinical Use