• Type: Second generation cephalosporin
  • Dosage Forms: powder for injection
  • Dosage Strengths: 1g, 2g, 10g
  • Route of Administration: IV
  • Common Trade Names: Mefoxin

Adult Dosing

  • 1-2g IV q6-8h

Pediatric Dosing

  • <3 months old: Safety & efficacy not established
  • >3 months old: 80-160 mg/kg/day IV divided q4-6hr; higher dosages should be used for more severe or serious infections

Special Populations

  • Pregnancy: Category B
  • Lactation: Minimal excretion in breast milk, limited data on affect to infant
  • Renal Dosing
    • CrCl 30-50 mL/min: 1-2 g q8-12hr
    • CrCl 10-30 mL/min: 1-2 g q12-24hr
    • CrCl 5-9 mL/min: 500 mg-1 g q24-28hr
    • CrCl <5 mL/min: 500 mg-1 g q24-48hr
  • Hepatic Dosing: not defined


  • Allergy to class/drug
  • Neonates

Adverse Reactions


  • Diarrhea
  • Anemia, thrombocytopenia, transient leukopenia
  • Elevated Cr/BUN
  • Elevated LFTs


  • Half-life: 45-60 min
  • Metabolism:
  • Excretion: Unchanged in urine (85%)
  • Mechanism of Action: Inhibits bacterial cell wall synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeS
Viridans strepS
Strep. anginosus gpX1
Enterococcus faecalisR
Enterococcus faeciumX1
Staph. EpidermidisI
C. jeikeiumR
L. monocytogenesR
Gram NegativesN. gonorrhoeaeI
N. meningitidisI
Moraxella catarrhalisS
H. influenzaeS
E. coliS
Klebsiella spS
E. coli/Klebsiella ESBL+R
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negR
Enterobacter sp, AmpC posR
Serratia spR
Serratia marcescensX1
Salmonella spX1
Shigella spX1
Proteus mirabilisS
Proteus vulgarisS
Providencia sp.S
Morganella sp.S
Citrobacter freundiiR
Citrobacter diversusI
Citrobacter sp.I
Aeromonas spI
Acinetobacter sp.R
Pseudomonas aeruginosaR
Burkholderia cepaciaR
Stenotrophomonas maltophiliaR
Yersinia enterocoliticaI
Francisella tularensisX1
Brucella sp.X1
Legionella sp.R
Pasteurella multocidaX1
Haemophilus ducreyiS
Vibrio vulnificusX1
MiscChlamydophila spX1
Mycoplasm pneumoniaeX1
Rickettsia spX1
Mycobacterium aviumX1
Bacteroides fragilisS
Prevotella melaninogenicaS
Clostridium difficileR
Clostridium (not difficile)S
Fusobacterium necrophorumS
Peptostreptococcus sp.S


  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also


  1. Sanford Guide to Antimicrobial Therapy 2014
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