Child dosage ages 3 months to 12 years who can swallow tablets whole : The typical dosage is mg every 12 hours for 10 days.
Child dosage ages 13 to 17 years : The typical dosage is 1, mg as a single dose. For early Lyme disease Adult dosage ages 18 years and older : The typical dosage is mg every 12 hours for 20 days.
Child dosage ages 13 to 17 years : The typical dosage is mg every 12 hours for 20 days. Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice.
Always speak with your doctor or pharmacist about dosages that are right for you. Take as directed Cefuroxime oral tablet is used for short-term treatment. It should only be used to treat bacterial infections.
It should not be used for viruses such as the common cold. For this drug to work well, a certain amount needs to be in your body at all times. If you take too much: You could have dangerous levels of the drug in your body.
Symptoms of an overdose of this drug can include sudden, irregular movements of any limb or part of the body. If your symptoms are severe, call or go to the nearest emergency room right away. What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose.
Never try to catch up by taking two doses at once. This could result in dangerous side effects. How to tell if the drug is working: You should notice a decrease in your symptoms. Your infection should heal. Keep these considerations in mind if your doctor prescribes cefuroxime oral tablet for you. General Take this drug at the time s recommended by your doctor. Cefuroxime oral tablet may be taken with or without food. Cefuroxime oral tablet should not be cut or crushed.
Refills A prescription for this medication is refillable. Overdose symptoms may include seizure black-out or convulsions. What should I avoid while taking cefuroxime?
Antibiotic medicines can cause diarrhea , which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to. Cefuroxime side effects Get emergency medical help if you have signs of an allergic reaction: hives ; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have: severe stomach pain, diarrhea that is watery or bloody; jaundice yellowing of the skin or eyes ; skin rash , bruising, severe tingling, or numbness ; seizure black-out or convulsions ; kidney problems--little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or severe skin reaction--fever, sore throat , swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads especially in the face or upper body and causes blistering and peeling.
Common side effects may include: diarrhea; unusual or unpleasant taste in your mouth; or diaper rash in an infant taking liquid cefuroxime. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. See also: Cefuroxime side effects in more detail What other drugs will affect cefuroxime? Tell your doctor about all your current medicines and any you start or stop using, especially: a blood thinner such as warfarin Coumadin , Jantoven ; or a diuretic or "water pill.
Other drugs may interact with cefuroxime, including prescription and over-the-counter medicines, vitamins , and herbal products. Not all possible interactions are listed in this medication guide. See also: Cefuroxime drug interactions in more detail Further information Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright Cerner Multum, Inc. Version: 7. Ceftin is not approved for use by anyone younger than 3 months old. How should I take Ceftin? Take Ceftin exactly as it was prescribed for you.
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. You may take Ceftin tablets with or without meals. Do not crush the tablet or it could have an unpleasant bitter taste. Ceftin oral suspension liquid must be taken with food. Shake the liquid well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup.
If you do not have a dose-measuring device, ask your pharmacist for one. If you switch from using the tablet form to using the liquid form, you may not need to use the same exact dosage in number of milligrams. This medicine may not be as effective unless you use the exact form and strength your doctor has prescribed. Use this medicine for the full prescribed length of time.
Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Ceftin will not treat a viral infection such as the flu or a common cold. This medicine can cause unusual results with certain lab tests for glucose sugar in the urine.
Minimize drug interactions by taking Ceftin that is chemically validated.
List This medication is also available in an injectable form to be given directly into a vein IV or a muscle IM by a healthcare professional. If it is almost time for sores next dose, skip the missed dose and take your next dose at the regular time. Brush and floss your teeth gently and continue to practice good oral hygiene. Every effort has been made to ensure that cefadroxil information is accurate, up-to-date, and complete, but no guarantee is made ceftin that effect.
Different individuals may respond to medication ceftin different ways. Kounis and type I variant mouth diagnosed secondary to the drug. Store the tablets at room temperature away from moisture and heat.
Side-effects are common, but mild. Autoimmune diseases, which may cause mouth sores to form. Diagnosis In most cases, a person can determine the cause of their mouth sore themselves.
Side-effects to include. Ceftin and Pregnancy Back to Top Tell your doctor if you are pregnant or plan antibiotic become pregnant. Cefuroxime is also more active than cefazolin against H. If treat is almost cefadroxil for the next dose, skip the missed dose ceftin take your next dose at ceftin regular time.
This is especially helpful for canker sores. It is also used to prevent infections during surgery 9. Come here medicine should used used with caution in patients with a history of kidney diseases.
These stones can develop in the salivary glands under your tongue, or in the salivary glands on the sides of your mouth.
Quitting smoking and acidic foods can aggravate mouth ulcers. It is important to note that a doctor or dentist should examine any new ulcer and any ulcer lasting longer than 3 weeks.
For most people, mouth ulcers will clear up within 2 weeks. Share on Pinterest Acidic foods, such as citrus fruits, may aggravate mouth ulcers. The exact cause of mouth ulcers is still not known and varies from person-to-person. Still, there are some common causes and several factors that may aggravate mouth ulcers, including the following: quitting smoking citrus fruits and other foods high in acidity or spice biting the tongue or inside of the cheek braces, poor-fitting dentures, and other apparatus that may rub against the mouth and gums a deficient filling hormonal changes during pregnancy, puberty , and menopause medications including beta-blockers and pain killers genetic factors Some people may develop ulcers as a result of a different medical condition or a nutritional deficiency.
Are mouth ulcers cancerous? Mouth cancer and mouth ulcers are distinctive in their symptoms. However, as mentioned earlier, new or persistent ulcers require checking. There are some fundamental differences between mouth ulcers and what might be cancer: Mouth ulcers are often painful whereas mouth cancer is not.
Mouth ulcers will clear up in about 2 weeks, whereas mouth cancer will not go away and will often spread. Mouth cancer patches may be rough, hard, and not easy to scrape off.
Mouth cancer is often a mix of red and white areas or large white areas that appear on the tongue, the back of the mouth, the gums, or on the cheeks. Mouth cancer is often linked to heavy drinking or tobacco use. Treatment In many cases, the pain and discomfort from mouth ulcers will lessen in a few days and then disappear in about 2 weeks with no need for treatment. For people with much more painful or frequent recurrence of mouth ulcers, a dentist may prescribe a solution to reduce swelling and lessen pain.
Also, a dentist may prescribe an antimicrobial mouthwash or an ointment to be applied directly to the infected patch. This can help to ease discomfort. Various mouth ulcer treatments are also available to purchase online.
Share on Pinterest The symptoms of a mouth ulcer may vary depending on the type of ulcer. Standard ulcers appear on the inner cheeks and last for about 1 week. Most are harmless and clear up with no medical intervention. Hand, foot, and mouth disease, which causes small, painful red patches to appear on these parts of the body.
It is most common in children. Leukoplakia, which causes white-grey patches to appear nearly anywhere in the mouth. Autoimmune diseases, which may cause mouth sores to form.
Erythroplakia, a red patch that appears on the floor of the mouth and can be cancerous or precancerous. Oral cancer, which can cause sores and lesions in the mouth. Diagnosis In most cases, a person can determine the cause of their mouth sore themselves. For example, a person who has had a canker sore before will recognize another one if it appears. A person who bites their cheek will know that the sore came from this incident.
People with diagnosed conditions, such as herpes of the mouth, may recognize their symptoms and have a plan of action to address the flare. If a person has recurrent or unexplained mouth sores, a doctor may be able to identify the cause of the sores by carrying out a visual check.
See Uses: Gonorrhea and Associated Infections. In addition, cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten include in their spectrum species hitherto resistant to oral used Proteus vulgaris, Providencia spp. Ceftin the optimal duration of therapy has not been established, most treat treat antibiotic Lyme disease for days.
Pharyngitis and Tonsillitis Oral cephalosporins e. Prolonged anti-infective therapy e. Ceftazidime but not sores, ceftizoxime, or ceftriaxone is considered a drug of choice for the treatment of infections caused by susceptible Pseudomonas aeruginosa; an aminoglycoside may be used concomitantly. When serologic testing is indicated and aid in diagnosis, the CDC and Association of State, Mouth, and Public Health Laboratory Directors ASTPHLDand other clinicians recommend initial testing with a sensitive screening test, either an enzyme-linked immunosorbent assay ELISA or an indirect fluorescent antibody IFA test, followed by testing with the more specific Ceftin blot immunoblot test to corroborate equivocal or positive results obtained with the initial test.
Selection of an anti-infective agent regimen for the treatment of S. The empiric cefadroxil recommended for infants in this age group is IV ampicillin ceftin either IV ceftriaxone or IV cefotaxime. Some clinicians state that IV ceftriaxone may be preferable to IV penicillin G for serious manifestations of early disseminated is robaxin available in late Lyme disease i.
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In addition, cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten include in their spectrum species hitherto resistant to oral cephalosporins Proteus vulgaris, Providencia spp. Chronic Suppurative Otitis Media without Cholesteatoma Ceftazidime has been used with some success in the treatment of chronic suppurative otitis media CSOM without cholesteatoma.
Ceftriaxone is considered a drug of choice for the treatment of most N. Because S. CAP patients usually have a here response within days after initiation of therapy and failure to respond to the initial empiric regimen generally indicates an incorrect diagnosis, host failure, inappropriate anti-infective regimen drug selection, dosage, levitra andunusual pathogen, adverse drug reaction, or complication and.
Although no longer routinely recommended, some clinicians suggest sores use of anti-infective prophylaxis may be considered for selected children with 3 or more documented episodes of AOM antibiotic a 6-month period or 4 or more episodes within a month period and also can be considered for children who treat an episode of AOM within the first 6 months of life or 2 episodes within the first year used life ceftin they have a family history of ear infections.
Cefuroxime axetil is an effective alternative ceftin that, because of its greater cost, is recommended for patients with early Lyme disease mouth are allergic to or intolerant of doxycycline ceftin amoxicillin.
Cefadroxil of Late Disease.
However, fluoroquinolones should not be used for the treatment of gonorrhea acquired in Asia or the pacific islands including Hawaii and may be inadvisable for infections acquired in other areas where N. In addition, there is evidence that overuse of anti-infectives, including overuse ceftin the treatment of AOM, contributes to emergence of resistant bacteria e. Gram-positive Bacterial Infections Third generation cephalosporins generally are less active than first and second generation cephalosporins against gram-positive bacteria, especially staphylococci, and usually are not used in the treatment of infections caused by gram-positive bacteria when a penicillin or a first or cefadroxil generation cephalosporin could be used.
Cephalosporins also are used parenterally for the treatment of intra-abdominal, biliary tract, and gynecologic infections including pelvic inflammatory disease caused by susceptible bacteria. Pharmacology of Cefuroxime as the 1-acetoxyethyl ester in ceftin.
The initial parenteral regimen should be continued for hours after improvement begins; cefadroxil can then be switched to oral cefixime, oral ciprofloxacin, oral ofloxacin, or oral levofloxacin and continued to complete read more least 1 week of treatment.
Biopharm Drug Dispos.
The IDSA states that, when an oral cephalosporin is used for the treatment antibiotic CAP, cefpodoxime, cefprozil, or cefuroxime axetil generally is preferred over other possibilities because of their in vitro activity against S. The AAP and other clinicians generally recommend that meningitis or other severe infection caused by L. Anti-infective therapy usually is effective in all stages of the disease, and appropriate treatment of early Lyme disease shortens the duration of symptoms and generally prevents the development of late sequelae.
Cefotaxime, cefoxitin, ceftizoxime, ceftriaxone, and cefuroxime are used parenterally for the treat of uncomplicated gonorrhea or other gonococcal infections; cefepime, ceftazidime, and ceftriaxone are used for empiric anti-infective therapy in https://www.medic8.com/nutrition/heart-health/health/careprost-application.html neutropenic patients; and ceftin, cefotaxime, ceftriaxone, and cefuroxime are ceftin parenterally for perioperative prophylaxis.
In some cases of persistent or recurrent AOM, identification of the causative organism by tympanocentesis or culture of cefadroxil ear fluid drainage may used appropriate.
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An empiric regimen of IV ceftriaxone or IV cefotaxime usually is used for empiric therapy of suspected bacterial meningitis in children 3 months through 17 years of age and in adults years of age.
Although an empiric regimen of IV ampicillin and IV chloramphenicol can be used as an alternative regimen in children 3 months through 17 years of age, most clinicians prefer a cephalosporin regimen unless the drugs are contraindicated. Because of the increasing prevalence of penicillin-resistant S.
The CDC and some clinicians have recommended that vancomycin be added to the empiric regimen in areas where there have been reports of highly penicillin-resistant strains of S. While L. In adults older than 50 years of age, bacterial meningitis usually is caused by S. Meningitis Caused by Streptococcus pneumoniae IV ceftriaxone and IV cefotaxime are considered drugs of choice for the treatment of meningitis caused by susceptible S.
While cefotaxime and ceftriaxone generally have been considered the drugs of choice for the treatment of meningitis caused by penicillin-resistant S.
In addition, strains of S. The prevalence of S. Because susceptibility can no longer be assumed, S. If anti-infective therapy in a patient with meningitis is initiated with an empiric regimen of IV ceftriaxone or IV cefotaxime and IV vancomycin with or without rifampin and results of culture and in vitro susceptibility testing indicate that pathogen involved is a strain of S.
If the isolate is found to have reduced susceptibility to ceftriaxone and cefotaxime and penicillin, the IV cephalosporin and IV vancomycin usually are both continued.
If the patient's condition does not improve or worsens or results of a second repeat lumbar puncture performed hours after initiation of anti-infective therapy indicate that the anti-infective regimen has not eradicated or substantially reduced the number of pneumococci in CSF, rifampin probably should be added to the regimen or vancomycin discontinued and replaced with rifampin.
If meningitis is caused by S. Meningitis Caused by Haemophilus influenzae IV ceftriaxone and IV cefotaxime are considered drugs of choice for the initial treatment of meningitis caused by susceptible H. The AAP suggests that children with meningitis possibly caused by H.
Because of the prevalence of ampicillin-resistant H. The incidence of H. Chloramphenicol is recommended for the treatment of N. Meningitis Caused by Enterobacteriaceae Some clinicians recommend that meningitis caused by Enterobacteriaceae e. Because ceftazidime but not cefotaxime or ceftriaxone is effective for the treatment of meningitis caused by Ps.
Meningitis Caused by Pseudomonas aeruginosa In patients with meningitis caused by Ps. If the patient fails to respond to this regimen, concomitant use of intrathecal or intraventricular aminoglycoside therapy or use of an alternative parenteral anti-infective e.
When treating pediatric patients with meningitis caused by Ps. Meningitis Caused by Streptococcus agalactiae For the initial treatment of meningitis or other severe infection caused by S.
Some clinicians suggest that IV ampicillin is the drug of choice for the treatment of group B streptococcal meningitis and that an aminoglycoside IV gentamicin should be used concomitantly during the first 72 hours until in vitro susceptibility testing is completed and a clinical response if observed; thereafter, ampicillin can be given alone.
Meningitis Caused by Listeria monocytogenes The optimal regimen for the treatment of meningitis caused by L. Cephalosporins are not active against Listeria monocytogenes, an organism that most frequently causes meningitis in neonates or immunocompromised individuals, and the drugs should not be used alone for empiric treatment of meningitis when this organisms may be involved.
The AAP and other clinicians generally recommend that meningitis or other severe infection caused by L. In patients hypersensitive to penicillin, the alternative regimen for treatment of meningitis caused by L. The choice of anti-infectives for empiric therapy of these infections should be based on the predisposing condition and site of primary infection. Some clinicians suggest that the empiric anti-infective regimen in patients who develop the CNS infections after respiratory tract infection e.
If presence of staphylococci is suspected, a penicillinase-resistant penicillin e. In patients who develop brain abscess, subdural empyema, or intracranial epidural abscess after trauma or neurosurgery, the empiric regimen should consist of an appropriate third generation IV cephalosporin e. Prolonged anti-infective therapy e. Respiratory Tract Infections Community-acquired Pneumonia Some oral cephalosporins cefdinir, cefpodoxime proxetil, cefprozil, cefuroxime axetil and some parenteral cephalosporins cefepime, cefotaxime, ceftriaxone are used in the treatment of community-acquired pneumonia CAP.
Initial treatment of CAP generally involves use of an empiric anti-infective regimen based on the most likely pathogens; therapy may then be changed if possible to a pathogen-specific regimen based on results of in vitro culture and susceptibility testing, especially in hospitalized patients. The most appropriate empiric regimen varies depending on the severity of illness at the time of presentation and whether outpatient treatment or hospitalization in or out of an intensive care unit ICU is indicated and the presence or absence of cardiopulmonary disease and other modifying factors that increase the risk of certain pathogens e.
For both outpatients and inpatients, most experts recommend that an empiric regimen for the treatment of CAP includes an anti-infective active against S. Therefore, for empiric outpatient treatment of acute CAP in immunocompetent adults, the IDSA recommends monotherapy with an oral macrolide azithromycin, clarithromycin, erythromycin , oral doxycycline, or an oral fluoroquinolone active against S. The IDSA states that, when an oral cephalosporin is used for the treatment of CAP, cefpodoxime, cefprozil, or cefuroxime axetil generally is preferred over other possibilities because of their in vitro activity against S.
For outpatient treatment of CAP in immunocompetent adults without cardiopulmonary disease or other modifying factors that would increase the risk of multidrug-resistant S. The CDC suggests that use of these oral fluoroquinolones in the outpatient treatment of CAP be reserved for when other anti-infectives are ineffective or cannot be used or when highly penicillin-resistant S.
In addition, anaerobic infection should be suspected in patients with aspiration pneumonia or lung abscess. Inpatient treatment of CAP is initiated with a parenteral regimen, although therapy may be changed to an oral regimen if the patient is improving clinically, is hemodynamically stable, and able to ingest drugs. CAP patients usually have a clinical response within days after initiation of therapy and failure to respond to the initial empiric regimen generally indicates an incorrect diagnosis, host failure, inappropriate anti-infective regimen drug selection, dosage, route , unusual pathogen, adverse drug reaction, or complication e.
If anaerobes are documented or lung abscess is present, clindamycin or metronidazole should be added to the regimen. For CAP patients admitted to a general patient-care setting who do not have cardiopulmonary disease or other modifying factors, the ATS suggests an empiric regimen of monotherapy with IV azithromycin; for those with macrolide sensitivity or intolerance, a 2-drug regimen of doxycycline and a b-lactam or monotherapy with a fluoroquinolone active against S.
If risk factors for Ps. Therefore, the ATS recommends that these patients receive a 2-drug empiric regimen that includes an IV antipseudomonal b-lactam anti-infective e. The choice of anti-infective agent for the treatment of sepsis syndrome should be based on the probable source of infection, gram-stained smears of appropriate clinical specimens, the immune status of the patient, and current patterns of bacterial resistance within the hospital and local community.
Certain parenteral cephalosporins i. Ceftazidime is less active against gram-positive cocci, and most cephalosporins except cefepime and ceftazidime have limited activity against Ps. For the initial treatment of life-threatening sepsis in adults unless presence of anaerobic bacteria, oxacillin-resistant staphylococci [previously known as methicillin-resistant staphylococci], or bacterial endocarditis is suspected , some clinicians suggest that use of a parenteral cephalosporin i.
For treatment of suspected bacteremia in neutropenic patients, suggested regimens for initial therapy include cefepime, ceftazidime, imipenem, or meropenem used alone or, in seriously ill patients, used in conjunction with an aminoglycoside amikacin, gentamicin, tobramycin.
A regimen of either ticarcillin and clavulanate potassium or piperacillin sodium and tazobactam sodium used in conjunction with amikacin may be equally effective. Gonorrhea and Associated Infections Cefoxitin, cefotaxime, ceftizoxime, ceftriaxone, and cefuroxime are used parenterally and cefixime, and cefpodoxime proxetil, and cefuroxime axetil are used orally for the treatment of uncomplicated gonorrhea caused by penicillinase-producing Neisseria gonorrhoeae PPNG or nonpenicillinase-producing N.
Cefoxitin, cefotaxime, ceftizoxime, ceftriaxone, and cefuroxime also are used parenterally for the treatment of disseminated gonorrhea and other gonococcal infections and oral cefixime is used for follow-up therapy after initial therapy with a parenteral cephalosporin for the treatment of disseminated gonococcal infections. Ceftriaxone is considered a drug of choice for the treatment of most N.
Ceftriaxone also is used in conjunction with other agents for empiric anti-infective prophylaxis in sexual assault victims. The CDC states that, although other parenteral or oral cephalosporins may be as effective as ceftriaxone in the treatment of gonococcal infections, they do not appear to offer any clear advantage over ceftriaxone. Based on experience in adults, the AAP states that use of oral cefixime can be considered for the treatment of uncomplicated gonorrhea in young children provided that follow-up can be assured.
The CDC and many clinicians currently recommend that uncomplicated cervical, urethral, or rectal infections caused by penicillinase-producing N. However, fluoroquinolones should not be used for the treatment of gonorrhea acquired in Asia or the pacific islands including Hawaii and may be inadvisable for infections acquired in other areas where N. Alternative regimens that are recommended by the CDC for the treatment of uncomplicated cervical, urethral, or rectal gonorrhea in adults and adolescents include a single IM dose of spectinomycin, a single IM dose of certain cephalosporins ceftizoxime, cefotaxime, cefoxitin , or a single oral dose of certain fluoroquinolones gatifloxacin, lomefloxacin, norfloxacin given in conjunction with an anti-infective regimen effective for presumptive treatment of chlamydia.
Uncomplicated pharyngeal gonococcal infections should be treated with a single IM dose of ceftriaxone or, alternatively, a single oral dose of ciprofloxacin given in conjunction with an anti-infective regimen effective for presumptive treatment of chlamydia. For the treatment of disseminated gonococcal infections in adults and adolescents, the CDC and many clinicians recommend that therapy be initiated with a multiple-dose regimen of IM or IV ceftriaxone.
Alternative regimens recommended by the CDC for disseminated gonococcal infections include multiple-dose parenteral regimens of certain IV cephalosporins cefotaxime, ceftizoxime , certain IV fluoroquinolones ciprofloxacin, levofloxacin , or IM spectinomycin. The initial parenteral regimen should be continued for hours after improvement begins; therapy can then be switched to oral cefixime, oral ciprofloxacin, oral ofloxacin, or oral levofloxacin and continued to complete at least 1 week of treatment.
Unless presence of coexisting chlamydial infection has been excluded by appropriate testing, individuals being treated for disseminated gonococcal infections should also receive an anti-infective regimen effective for presumptive treatment of chlamydia. The CDC and AAP recommend that neonates and infants with localized gonococcal scalp abscesses or disseminated gonococcal infections should receive ceftriaxone or cefotaxime.
For the treatment of uncomplicated or disseminated gonococcal infections in prepubertal children who weigh less than 45 kg, the CDC and AAP generally recommend use of IM or IV ceftriaxone.
Children weighing 45 kg or more generally can receive regimens recommended for adults and adolescents. The CDC states that oral cephalosporins have not been adequately evaluated for the treatment of gonococcal infections in children.
Gonorrhea frequently is associated with coexisting chlamydial and mycoplasmal infections; however, cephalosporins, penicillins, spectinomycin, and most single-dose quinolone regimens are ineffective in the treatment of these coexisting infections. Because of the risks associated with untreated coexisting chlamydial infections, the CDC and most clinicians currently state that therapy for uncomplicated gonorrhea or disseminated gonococcal infections should be given in conjunction with presumptive treatment for chlamydia.
For additional information on current recommendations for the treatment of gonorrhea and associated infections, see Uses: Gonorrhea and Associated Infections in Ceftriaxone Pelvic Inflammatory Disease Several parenteral cephalosporins cefotaxime, ceftizoxime, ceftriaxone and closely related cephamycins cefotetan, cefoxitin have been used in the treatment of acute pelvic inflammatory disease PID ; these drugs are inactive against C.
PID is an acute or chronic inflammatory disorder in the upper female genital tract and can include any combination of endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis.
PID generally is a polymicrobial infection most frequently caused by N. PID is treated with an empiric regimen that provides broad-spectrum coverage. The regimen should be effective against N.
The optimum empiric regimen for the treatment of PID has not been identified. A wide variety of parenteral and oral regimens have been shown to achieve clinical and microbiologic cure in randomized studies with short-term follow-up; however, only limited data are available to date regarding elimination of infection in the endometrium and fallopian tubes or intermediate or long-term outcomes, including the impact of these regimens on the incidence of long-term sequelae of PID e.
Although many clinicians have recommended that all patients with acute PID be hospitalized so that bedrest and supervised treatment with parenteral anti-infectives could be initiated, the CDC currently states that decisions regarding the necessity for hospitalization and whether an oral or parenteral regimen are most appropriate should be made on an individual basis since data are not available to date comparing efficacy of parenteral or oral therapy or inpatient or outpatient therapy.
Based on observational data and theoretical concerns, the CDC states that hospitalization is indicated if surgical emergencies such as appendicitis cannot be excluded; the patient is pregnant; the patient is unable to follow or tolerate an outpatient oral regimen; the patient has severe illness, nausea and vomiting, or high fever; the patient has a tuboovarian abscess; or a clinical response was not obtained with an oral anti-infective regimen. While there is some evidence that certain parenteral cephalosporins e.
The CDC states that limited data support the use of several alternative parenteral regimens for the treatment of acute PID, including IV levofloxacin with or without IV metronidazole or IV ampicillin sodium and sulbactam sodium with oral or IV doxycycline. Traditionally, parenteral regimens for the treatment of PID have been continued for at least 48 hours after the patient demonstrates substantial clinical improvement and then an oral regimen continued to complete a total of 14 days of therapy; however, the CDC states that a transition to oral therapy may occur within 24 hours after the patient demonstrates clinical improvement and that decisions regarding such a transition should be guided by clinical experience.
Most clinicians recommend at least 24 hours of direct inpatient observation for patients with tubo-ovarian abscesses, after which time anti-infective therapy at home is adequate. Oral Regimens for PID When PID is treated with an oral regimen, the CDC recommends a day regimen that consists of oral ofloxacin mg twice daily or oral levofloxacin mg once daily with or without oral metronidazole mg twice daily for 14 days or a regimen that consists of a single dose of a parenteral cephalosporin e.
Although ofloxacin is effective against both N. The optimal parenteral cephalosporin for the second regimen is unclear, although cefoxitin or ceftriaxone usually is preferred. Data are not available to date regarding use of oral cephalosporins for the treatment of PID. There is evidence from clinical trials that a single dose of IM cefoxitin given with probenecid effectively produces a short-term clinical response in women with PID; however, because of theoretical limitations in cefoxitin's coverage of anaerobes, the addition of metronidazole to the regimen may be necessary.
In addition, metronidazole should be effective in the treatment of bacterial vaginosis, which is frequently associated with PID. There are limited data suggesting that use of oral doxycycline and oral metronidazole after primary parenteral therapy is safe and effective. Patient Follow-up and Management of Sexual Partners Regardless of whether an oral or parenteral regimen is used, patients with PID should demonstrate substantial clinical improvement e. In women who had documented infections with N.
Sexual partners of women with PID should be examined and treated if they had sexual contact during the 60 days preceding the onset of symptoms in the patients.
Evaluation and treatment are imperative because of the risk for reinfection and the strong likelihood of urethral gonococcal or chlamydial infection in the partner. Male partners of women with PID caused by N. Sex partners should be treated empirically with regimens effective against these organisms, regardless of the apparent etiology of PID or pathogens isolated from the infected woman.
Chancroid Ceftriaxone is used for the treatment of genital ulcers caused by H. See Uses: Chancroid, in Ceftriaxone Sodium Lyme disease Lyme borreliosis is a spirochetal disease caused by Borrelia burgdorferi.
Anti-infective therapy usually is effective in all stages of the disease, and appropriate treatment of early Lyme disease shortens the duration of symptoms and generally prevents the development of late sequelae. Diagnostic Considerations Diagnosis of Lyme disease is based principally on clinical findings, and treating patients with early disease solely on the basis of objective signs and a known exposure often is appropriate. Individuals with known endemic exposure to B.
In areas of low or no endemic risk, the likelihood of Lyme disease in a patient with a rash resembling erythema migrans is low. Serologic testing can provide valuable supportive diagnostic information in patients with endemic exposure and objective clinical findings that indicate later stage disseminated Lyme disease. Negative test results are useful in ruling out Lyme disease in patients with clinical findings compatible with disseminated or late-stage infection.
Since the proportion of false-positive test results increases when the pretest probability of Lyme disease is low, the use of testing to make a diagnosis of Lyme disease in individuals without endemic exposure is not recommended. The CDC and National Institute of Allergy and Infectious Diseases NIAID state that clinicians should be familiar with current recommendations for diagnosis and treatment of Lyme disease and should be alert for and know how to minimize potential complications associated with therapy for the disease.
When serologic testing is indicated to aid in diagnosis, the CDC and Association of State, Territorial, and Public Health Laboratory Directors ASTPHLD , and other clinicians recommend initial testing with a sensitive screening test, either an enzyme-linked immunosorbent assay ELISA or an indirect fluorescent antibody IFA test, followed by testing with the more specific Western blot immunoblot test to corroborate equivocal or positive results obtained with the initial test.
Although anti-infective treatment in early localized disease may blunt or abrogate the antibody response, patients with early disseminated or late-stage disease usually have strong serologic reactivity and demonstrate expanded IgG Western blot banding patterns to diagnostic B. Antibodies often persist for months or years following successfully treated or untreated infection.
Therefore, seroreactivity alone cannot be used as a marker of active disease. Repeated infection with B. Treatment of Early Localized or Disseminated Disease The IDSA, AAP, and other clinicians recommend the use of oral doxycycline or oral amoxicillin as first-line therapy for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans, in the absence of neurologic involvement or third-degree atrioventricular AV heart block.
Cefuroxime axetil is an effective alternative agent that, because of its greater cost, is recommended for patients with early Lyme disease who are allergic to or intolerant of doxycycline and amoxicillin. Although the optimal duration of therapy has not been established, most clinicians treat early Lyme disease for days.
Available evidence suggests that first generation cephalosporins e. Transplacental transmission of B. The IDSA, AAP, and other clinicians state that pregnant or nursing women need not be treated differently than other patients with Lyme disease, except that they should not receive tetracyclines.
Although oral anti-infectives e. While evidence supporting the superiority of IV versus oral therapy currently is unavailable, most clinicians recommend that patients with severe cardiac involvement receive ceftriaxone, cefotaxime, or penicillin G IV for days.
Some clinicians also recommend use of these IV regimens in patients with first-degree AV block and a PR-interval greater than 0. The IDSA and other clinicians recommend that patients with third-degree AV heart block be hospitalized for cardiac monitoring because of the potential for life-threatening complications. Patients with third-degree AV block may require a temporary pacemaker. While patients with uncomplicated Lyme arthritis generally can be treated with a prolonged course e.
Some clinicians state that IV ceftriaxone may be preferable to IV penicillin G for serious manifestations of early disseminated or late Lyme disease i. The IDSA and other clinicians state that IV cefotaxime is an effective alternative to ceftriaxone or IV penicillin G in patients requiring parenteral anti-infective therapy for Lyme disease; while cefotaxime must be administered times daily compared with once-daily administration of ceftriaxone , cefotaxime has not been associated with the biliary complications reported with IV ceftriaxone.
DOI: In addition, cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten include in their spectrum species hitherto resistant to oral cephalosporins Proteus vulgaris, Providencia spp.
Ceftibuten is the most potent oral cephalosporin against most of the Enterobacteriaceae. Non-fermentative bacilli Acinetobacter spp. Antistaphylococcal activity for oral cephalosporins is highest for cefdinir followed by BAY , cefprozil, cefuroxime and cefpodoxime.
Loracarbef, cefaclor and cefadroxil are about equally active, while the other compounds are only weakly active cefixime or inactive cefetamet, ceftibuten. Enterococci are insensitive to new generation oral cephalosporins as they have been to established compounds.