cefprozil Nursing Considerations & Management

 Drug Name

Generic Name : cefprozil

Brand Name: Cefzil

Classification: Antibiotic, Cephalosporin (second generation)

Pregnancy Category B

Dosage & Route
Oral
  • Skin and soft tissue infections, Susceptible infections including upper and lower respiratory infections
  • Adult: 500 mg/day as a single dose or in 2 divided doses, increased to 500 mg bid if necessary.
  • Child: 20 mg/kg/day once or twice daily, up to a max dose of 500 mg once daily, if necessary, bid for otitis media.
Therapeutic actions
  • Cefprozil inhibits cell wall synthesis and has activity against a broad range of gram-positive and gram-negative bacteria.
    • Absorption: Well absorbed from the GI tract. Bioavailability: 90-95%.
    • Distribution: 35-45% bound to plasma proteins. Widely distributed in the body tissues.
    • Excretion: Plasma half-life: 1-1.4 hr; prolonged in renal impairment. About 60% excreted unchanged in the urine.
Indications
  • Pharyngitis or tonsillitis caused by Streptococcus pyogenes
  • Secondary bacterial infection of acute bronchitis and exacerbation of chronic bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis
  • Dermatologic infections caused by Staphylococcus aureus, S. pyogenes
  • Otitis media caused by S. pneumoniae, H. influenzae, M. catarrhalis
  • Acute sinusitis caused by S. pneumoniae, S. aureus, H. influenzae, M. catarrhalis
Adverse effects
  • Nausea; vomiting; diarrhea; hypersensitivity reactions; nephrotoxicity; convulsions; CNS toxicity; hepatic dysfunction; hematologic disorders; pain at Injection site (IM); thrombophlebitis (IV infusion); superinfection with prolonged use.
  • Potentially Fatal: Pseudomembranous colitis.
Contraindications
  • Hypersensitivity
Nursing considerations
Assessment
  • History: Penicillin or cephalosporin allergy, pregnancy or lactation, renal failure
  •  Physical: Renal function tests, respiratory status, skin status, culture and sensitivity tests of infected area
Interventions
  • Culture infection before drug therapy.
  • Give drug with food to decrease GI discomfort.
  • Refrigerate suspension after reconstitution, and discard after 14 days.
  • Discontinue if hypersensitivity reaction occurs.
  • Give the patient yogurt or buttermilk in case of diarrhea.
  • Arrange for oral vancomycin for serious colitis that fails to respond to discontinuation.
Teaching points
  • Take this drug with food.
  • Complete the full course of this drug, even if you feel better.
  • This drug is prescribed for this particular infection; do not use it to self-treat any other infection.
  • You may experience these side effects: Stomach upset, loss of appetite, nausea (take drug with food); diarrhea; headache, dizziness.
  • Report severe diarrhea with blood, pus, or mucus; rash or hives; difficulty breathing; unusual tiredness, fatigue; unusual bleeding or bruising.