Author: Brian Holtry

Cefdinir is used orally for the treatment of mild to moderate upper and lower respiratory tract infections (i.e., acute maxillary sinusitis, acute exacerbations of chronic bronchitis, community-acquired pneumonia) caused by susceptible bacteria. The drug also is used orally for the treatment of acute bacterial otitis media, streptococcal pharyngitis and tonsillitis, and mild to moderate, uncomplicated skin and skin structure infections caused by susceptible bacteria.

The manufacturer of Ceftin® (cefuroxime axetil) oral suspension states that safety and efficacy of the suspension have been established only for the treatment of pharyngitis and tonsillitis, acute otitis media, and impetigo caused by susceptible bacteria. Cefuroxime sodium is used parenterally in the treatment of lower respiratory tract infections (including pneumonia), serious skin and skin structure infections, genitourinary tract infections, bone and joint infections, septicemia, and meningitis caused by susceptible organisms.

Cefprozil is used orally for the treatment of mild to moderate respiratory tract infections (i.e., acute sinusitis, secondary bacterial infections of acute bronchitis, acute exacerbations of chronic bronchitis, community-acquired pneumonia) caused by susceptible bacteria.

Cefaclor capsules and oral suspension are used for the treatment of lower respiratory tract infections (including pneumonia) caused by susceptible S. pneumoniae, H. influenzae, or S. pyogenes. Cefaclor extended-release tablets are used for the treatment of mild to moderate acute exacerbations of chronic bronchitis or secondary infections of acute bronchitis caused by susceptible Haemophilus influenzae (non-b-lactamase-producing strains only), Moraxella (formerly Branhamella) catarrhalis (including b-lactamase-producing strains), or Streptococcus pneumoniae.

Cephradine is administered orally. Cephradine also has been administered by IM or IV injection and by IV infusion, but a parenteral dosage form no longer is commercially available in the US. For lobar pneumonia and serious urinary tract infections (including prostatitis), the usual adult oral dosage is 500 mg every 6 hours or 1 g every 12 hours. For severe or chronic infections, dosage may be increased up to 1 g every 6 hours.

Cefazolin is used for the treatment of respiratory tract infections, urinary tract infections, skin and skin structure infections, biliary tract infections, bone and joint infections, genital infections, septicemia, and endocarditis caused by susceptible bacteria.

Cephalosporins are semisynthetic b-lactam antibiotics that are structurally and pharmacologically related to penicillins, carbacephems (e.g., loracarbef), and cephamycins (e.g., cefotetan, cefoxitin). Cephalosporins generally are divided into 4 groups (“generations”) based on their spectra of activity. Cefaclor, cefadroxil, cefdinir, cefditoren pivoxil, cefpodoxime proxetil, cefprozil, ceftibuten, cefuroxime axetil, cephalexin, and cephradine also are used orally for the treatment of mild to moderate skin and skin structure infections caused by susceptible staphylococci or streptococci.

Commercially available tobramycin solution for oral inhalation is administered via nebulization in the management of bronchopulmonary Pseudomonas aeruginosa infections in cystic fibrosis patients 6 years of age or older. Use of tobramycin oral inhalation solution can be considered for suppressive therapy in cystic fibrosis patients colonized with Ps. aeruginosa if they are 6 years of age or older and have a forced expiratory volume in 1 second (FEV1) that is 25-75% of the predicted value. At baseline, the FEV1 in all study patients was 25-75% of the predicted value.