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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › OTHER BETA-LACTAM ANTIBACTERIALS › Third-generation cephalosporins
cefmenoxime
J01DD05
Forms & Strengths
- Injectable powder for solution: 500 mg, 1 g, 2 g per vial
Adult Dosing
- Uncomplicated infections: 1 g IV or IM every 12 hours
- Moderate to severe infections: 1 g to 2 g IV or IM every 6 to 8 hours
- Life-threatening infections: Up to 2 g IV every 4 hours
- Renal impairment adjustment: CrCl 10-50 mL/min: normal dose every 8-12 hours; CrCl < 10 mL/min: normal dose every 24 hours
Pediatric Dosing
- Neonates: 50 mg/kg/dose IV every 8 to 12 hours depending on postnatal age and weight
- Infants and children: 50 to 100 mg/kg/day IV or IM divided every 6 to 8 hours
- Severe infections: Up to 150 to 200 mg/kg/day divided every 4 to 6 hours
Indications
- Lower respiratory tract infections caused by Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella species
- Urinary tract infections caused by Escherichia coli, Proteus mirabilis, and Klebsiella species
- Intra-abdominal infections and peritonitis
- Skin and skin structure infections
- Septicemia caused by susceptible organisms
Mechanism of Action
- Third-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs)
- Exerts bactericidal activity against a broad spectrum of gram-positive and gram-negative aerobic bacteria
- Highly resistant to hydrolysis by most beta-lactamases
Contraindications
- Hypersensitivity to cefmenoxime or other cephalosporins
- History of immediate or severe hypersensitivity reaction (e.g., anaphylaxis) to penicillins or other beta-lactam agents
Adverse Reactions
- Hypersensitivity reactions including rash, pruritus, urticaria, and anaphylaxis
- Gastrointestinal effects including diarrhea, nausea, vomiting, and pseudomembranous colitis
- Hematologic effects including transient neutropenia, leukopenia, thrombocytosis, and positive direct Coombs test
- Hepatic effects including transient elevations in AST, ALT, and alkaline phosphatase
- Local reactions including pain, induration, and phlebitis at the injection site
- Risk of bleeding associated with the N-methylthiotetrazole side chain causing hypoprothrombinemia
Drug Interactions
- Aminoglycosides: Potential for additive nephrotoxicity and ototoxicity
- Loop diuretics: May increase the risk of nephrotoxicity
- Anticoagulants (warfarin): Potential enhancement of the hypoprothrombinemic effect and increased bleeding risk due to the NMTT side chain
- Alcohol: Disulfiram-like reaction (flushing, tachycardia, nausea) may occur due to inhibition of aldehyde dehydrogenase by the NMTT side chain
Curated Content: Needs Vetting Before Put to Clinical Use