C difficile risk
Oral Bioavailability


Usual DoseCNS infections or Enterococcus faecalis endocarditis in combination with ampicillinNote1–2g IV q24h2g IV q12hNo renal dosing changes required

General Information

  • EMPIRIC therapy of severely ill patients with suspected Gram-negative infection

  • Documented Gram-negative infection resistant to 1st and 2nd generation cephalosporins

  • Meningitis, brain abscess

  • Spontaneous bacterial peritonitis, community-acquired secondary peritonitis (or hospital acquired with no previous antimicrobial therapy), or intra-abdominal abscess.

  • Salmonella

  • Severe community-acquired pneumonia (DS-CRB65 ≥ 4 or ICU admission)

  • Gonorrhea

  • Pelvic Inflammatory Disease, Epididymitis

  • Some endocarditis infections

  • Synergy in some Enterococci endocarditis infections, particularly if gentamicin is contraindicated

  • Complicated Lyme infections


  • Does not cover Listeria, Pseudomonas, ESBLs or AmpC producing Enterobacteriaceae

  • Avoid in patients with biliary sludging or cholestatic hepatitis (see Cefotaxime)

  • Avoid for serious Citrobacter or Enterobacter infections, even if reported as susceptible

  •  Allergy/rash (immediate or delayed)

  •  Cytopenias

  •  Eosinophilia

  •  Hepatic & renal laboratory abnormalities

  •  Pseudocholelithiasis: more likely if on TPN and using ≥ 2g/day

  • Drug induced immune thrombocytopenia

Antimicrobial class: Parenteral Cephalosporin - 3rd Generation

Pregnancy category: B

Average serum half life: 8 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Biliary penetration: Therapeutic

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