First generation cephalosporin useful against most gram-positive cocci. Some Streptococci, many Klebsiella, Enterobacter, and Hemophilus influenzae, most Proteus vulgaris, nearly all Pseudomonas species are resistant. Give IV over 15-30 minutes. Action Inhibits synthesis of bacterial cell wall. Chemically closely related to penicillins, but not degraded by beta-lactamases.
Resistance is based on cephalosporinase production.
Methicillin-resistant Staphylococci are also usually resistant to the cephalosporins. Toxicity Very irritating substance. Large or repeated IM doses may produce severe pain, local induration, and occasional sterile abcesses. IV administration especially in infants may cause thrombophlebitis. Recent data suggest increased nephrotoxicity when used with an aminoglycoside.