View source for Cefacetrile

== General ==
* Type: 1st generation Cephalosporin
* Dosage Forms: Powder for injection
* Dosage Strengths: 500mg, 1g
* Routes of Administration: IV, IM
* Common Trade Names: Celospor, Celtol, Cristacef

== Adult Dosing ==
=== General ===
* Mild-Moderate: 500mg-1g IM/IV q6-8h
* Severe: 1-2g IM/IV q4-6h
* Max: 6g/day (up to 12g has been used in extreme cases historically, but 6g is standard limit)

=== Urinary Tract Infection (Uncomplicated) ===
* 500mg IM/IV q8h

=== Respiratory Tract Infections ===
* 1g IM/IV q6h

=== Surgical Prophylaxis ===
* 1g IM/IV x1 (30-60 min before procedure)
* May repeat q6h during prolonged surgery

== Pediatric Dosing ==
=== General (> 1 Month) ===
* 30-50mg/kg/day IM/IV divided q6-8h
* Severe Infections: Up to 80-100mg/kg/day IM/IV divided q4-6h
* Max: 4g/day (or adult max depending on weight)

=== Neonates (< 1 Month) ===
* Data is limited for this specific agent compared to Cefazolin.
* General 1st Gen recommendation: 20mg/kg/day IM/IV divided q12h

== Special Populations ==
* Pregnancy: B
* Lactation: Safe (Excreted in low concentrations)
* Renal
** Adult
*** CrCl >50: Usual regimen
*** CrCl 30-50: Usual dose q8h
*** CrCl 10-29: Usual dose q12h
*** CrCl <10: Usual dose q24h
*** Hemodialysis: Moderately dialyzable; administer dose after dialysis
** Pediatric
*** Specific tiered dosing not fully substantiated; follow adult interval extensions based on GFR.
* Hepatic
** No dosage adjustment usually required (Renal excretion).

== Contraindications ==
* Allergy to Cephalosporins
* History of anaphylactic reaction to Penicillins

== Adverse Reactions ==
=== Serious ===
* Anaphylaxis
* Angioedema
* Neutropenia (rare, reversible)
* Thrombocytopenia
* Pseudomembranous colitis (''C. difficile'')
* Nephrotoxicity (historically higher risk than newer agents, especially if combined with aminoglycosides)
* Elevated BUN/Creatinine

=== Common ===
* Phlebitis at injection site
* Pain at IM injection site
* Rash/Pruritus
* Diarrhea
* Nausea
* Eosinophilia
* Transient elevation of liver enzymes (AST/ALT)

== Pharmacology ==
* Half-life: 1.2 - 1.5h (increases significantly in renal impairment)
* Metabolism: Minimally metabolized; some deacetylation
* Excretion: Urine (mostly unchanged)
* Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

== Antibiotic Sensitivities ==
{| class="wikitable"
! Group !! Organism !! Sensitivity
|-
| rowspan="12" | '''Gram Positive'''
| Strep. Group A, B, C, G || '''S'''
|-
| Strep. Pneumoniae || '''S'''
|-
| Viridans strep || '''S'''
|-
| Strep. anginosus gp || X1
|-
| Enterococcus faecalis || R
|-
| Enterococcus faecium || X1
|-
| MSSA || '''S'''
|-
| MRSA || R
|-
| CA-MRSA || R
|-
| Staph. Epidermidis || I
|-
| C. jeikeium || R
|-
| L. monocytogenes || R
|-
| rowspan="27" | '''Gram Negatives'''
| N. gonorrhoeae || '''S'''
|-
| N. meningitidis || R
|-
| Moraxella catarrhalis || I
|-
| H. influenzae || I
|-
| E. coli || '''S'''
|-
| Klebsiella sp || '''S'''
|-
| E. coli/Klebsiella ESBL+ || R
|-
| E coli/Klebsiella KPC+ || R
|-
| Enterobacter sp, AmpC neg || R
|-
| Enterobacter sp, AmpC pos || R
|-
| Serratia sp || R
|-
| Serratia marcescens || R
|-
| Salmonella sp || X1
|-
| Shigella sp || X1
|-
| Proteus mirabilis || '''S'''
|-
| Proteus vulgaris || R
|-
| Providencia sp. || R
|-
| Morganella sp. || R
|-
| Citrobacter freundii || R
|-
| Citrobacter diversus || R
|-
| Citrobacter sp. || R
|-
| Aeromonas sp || R
|-
| Acinetobacter sp. || R
|-
| Pseudomonas aeruginosa || R
|-
| Burkholderia cepacia || R
|-
| Stenotrophomonas maltophilia || R
|-
| Yersinia enterocolitica || R
|-
| rowspan="6" | '''Additional GN'''
| Francisella tularensis || X1
|-
| Brucella sp. || X1
|-
| Legionella sp. || R
|-
| Pasteurella multocida || X1
|-
| Haemophilus ducreyi || X1
|-
| Vibrio vulnificus || X1
|-
| rowspan="4" | '''Misc'''
| Chlamydophila sp || X1
|-
| Mycoplasm pneumoniae || X1
|-
| Rickettsia sp || X1
|-
| Mycobacterium avium || X1
|-
| rowspan="7" | '''Anaerobes'''
| Actinomyces || '''S'''
|-
| Bacteroides fragilis || R
|-
| Prevotella melaninogenica || X1
|-
| Clostridium difficile || X1
|-
| Clostridium (not difficile) || I
|-
| Fusobacterium necrophorum || X1
|-
| Peptostreptococcus sp. || '''S'''
|}
Note: Cefacetrile shares the typical spectrum of "1st Generation" cephalosporins. "S" indicates Sensitive, "R" indicates Resistant, "I" indicates Intermediate, and "X1" typically indicates no data or specific reference required in the source material template.

==See Also==
*[[Cephalosporins]]
*[[Antibiotics]]

== References ==
* Martindale: The Complete Drug Reference
* Kucers' The Use of Antibiotics
* Sanford Guide to Antimicrobial Therapy (Historical Class Data)

[[Category:Pharmacology]] [[Category:ID]]