(2) In penicillin-sensitive clients, the cephalosporin derivatives should be
used with great caution. It has been estimated that about 10 percent of penicillin-
hypersensitive clients are also allergic to the cephalosporins.
(3) The addition of 10 to 25 mg of hydrocortisone to intravenous solutions
containing 4 to 6 grams of cephalothin may reduce the incidence of thrombophlebitis.
(4) Prolonged use of the cephalosporins may result in the overgrowth of
nonsusceptible organisms (superinfection).
(5) The cephalosporins will produce a false-positive reaction for glucose in
the urine with Benedict's solutions and Clinitest tablets but not with Tes-Tape.
(6)
Safety of the cephalosporins for use in pregnancy has not been
established.
d. Adverse Reactions.
(1) Injectable forms can produce severe pain after intramuscular injection,
while repeated intravenous injection may result in thrombophlebitis.
(2) Anaphylaxis, urticaria, skin rashes, fever, eosinophilia, granulocytopenia,
and hemolytic anemia may occur.
(3)
Renal toxicity has occurred with cephaloridine but not with cephalothin.
(4)
Oral cephalosporins have produced diarrhea, nausea, and vomiting.
e. Supply.
(1) Sterile sodium cephalothin (Keflin). Cephalothin is a semisynthetic
cephalosporin antibiotic for parenteral use only. Its use has not been associated with
renal toxicity. It is supplied in 1-gram, 2-gram, and 4-gram vials for reconstitution. It
may be refrigerated for 48 hours after reconstitution without loss of potency.
(2) Cephapirin for injection (Cefadyl). Cephapirin can be administered IM or
IV. Adults receive 500 mg to 1 gram every 4 to 6 hours. For serious infections up to 12
grams daily may be administered. The IV route must be used when higher doses are
required. Cephapirin is supplied in 500 mg, 1 gm, 2 gm, 4 gm, and 20 gm vials for
reconstitution.
(3) Cephalexin monohydrate (Keflex). Cephalexin is a semi- synthetic
cephalosporin intended for oral use only. It is included in the Battalion Aid Station
Medical Equipment Set. The main indications for this drug are as a follow-up antibiotic
for clients switching from a parenteral cephalosporin and for the treatment of urinary
tract infections resistant to antibiotics of first choice (that is, sulfonamides, ampicillin,
MD0913
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