Pregnancy Risk Category B
How supplied
Tablets: 250 mg, 500 mg
Oral suspension: 125 mg/5 ml, 250 mg/5 ml
Action
A second-generation cephalosporin that interferes with cell-wall synthesis during microorganism replication, leading to osmotic instability and cell lysis (bactericidal).
Indications & dosage
Pharyngitis or tonsillitis due to Streptococcus pyogenes-
Adults and children ages 13 and older: 500 mg P.O. daily for at least 10 days.
Otitis media due to S. pneumoniae, Haemophilus influenzae, and Moraxella (Branhamella) catarrhalis-
Infants and children ages 6 months to 12 years: 15 mg/kg P.O. q 12 hours for 10 days.
Secondary bacterial infections of acute bronchitis and acute bacterial exacerbation of chronic bronchitis due to S. pneumoniae, H. influenzae, and M. catarrhalis-
Adults and children ages 13 and older: 500 mg P.O. q 12 hours for 10 days.
Uncomplicated skin and skin-structure infections due to Staphylococcus aureus and S. pyogenes-
Adults and children ages 13 and older: 250 or 500 mg P.O. q 12 hours or 500 mg daily.
Acute sinusitis due to S. pneumoniae, H. influenzae (beta-lactamase positive and negative strains), and M. catarrhalis (including beta-lactamase-producing strains)-
Adults and children ages 13 and older: 250 mg P.O. q 12 hours for 10 days; for moderate to severe infection, 500 mg P.O. q 12 hours for 10 days.
Children ages 6 months to 12 years: 7.5 mg/kg P.O. q 12 hours for 10 days; for moderate to severe infections, 15 mg/kg P.O. q 12 hours for 10 days.
Adjust-a-dose: For patients with renal failure, if creatinine clearance is below 30 ml/minute, give 50% of usual dose.
Adverse reactions
CNS: dizziness, hyperactivity, headache, nervousness, insomnia, confusion, somnolence.
GI: diarrhea, nausea, vomiting, abdominal pain.
GU: elevated BUN level, elevated serum creatinine level, genital pruritus, vaginitis.
Hematologic: decreased leukocyte count, eosinophilia.
Hepatic: elevated liver enzymes, cholestatic jaundice (rare).
Skin: rash, urticaria, diaper rash.
Other: superinfection, hypersensitivity reactions, serum sickness, anaphylaxis.
Interactions
Drug-drug. Aminoglycosides: potential increased risk of nephrotoxicity. Monitor closely.
Probenecid: may inhibit excretion and increase blood levels of cefprozil. Use together cautiously.
Effects on diagnostic tests
Cephalosporins may produce a false-positive result for urine glucose tests that use copper reduction method (Benedict's reagent, Fehling's solution, or Clinitest tablets); use enzymatic glucose oxidase methods instead. A false-negative reaction may occur in the ferricyanide test for blood glucose.
Contraindications
Contraindicated in patients with hypersensitivity to drug or other cephalosporins.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING