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Medicine Overview of Dolocef IV/IM 1gm/vial Injection
বাংলা
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Indication
Pneumonia, Pharyngitis, Susceptible infections, Otitis media, Skin and Skin-Structure Infections, Rheumatic fever, Tonsillitis, Respiratory tract infections, Urinary tract infections, Surgical Prophylaxis, Genitourinary tract infections, Acute prostatitis
Administration
May be taken with or without food. May be taken w/ meals to reduce GI discomfort.
Parenteral doses by deep IM or slow IV inj over 3-5 min or by IV infusion.
Reconstitution: IM: Add 2 mL or 4 mL of sterile water for inj or NaCl 0.9% inj to 500 mg or 1 g vial, respectively.
IV: Add 5 mL of sterile water for inj, dextrose 5% inj, NaCl 0.9% inj or other suitable soln to 500 mg vial. Shake well the entire soln.
Adult Dose
Adult: PO Susceptible infections 1-2 g/day in 2-4 divided doses. Max: 4 g/day.
Surgical prophylaxis 1-2 g pre-op. Subsequent doses may be given as needed.
Skin and skin structures and respiratory tract infection: Usual dose is 250 mg every 6 hours or 500 mg every 12 hours.
Lobar pneumonia: 500 mg every 6 hours or 1 gm every 12 hours.
Urinary tract infection: Usual dose is 500 mg every 12 hours.
Gastro-intestinal tract infection: 500 mg three to four times daily.
IV/IM Severe infections 2-4 g/day in 4 divided doses. Max: 8 g/day.
Child Dose
Children: Oral: The usual total dose is 25 to 50 mg/kg/day given in 2 to 4 equally divided doses.
Injection: 50 to 100 mg/kg/day in 4 equally divided doses. The usual total dose may be increased up to 200-300 mg/kg/day.
Perioperative prophylaxis: Recommended dose is 1-2 gm by intramuscular or intravenous route; subsequent parenteral or oral doses are given as appropriate.
Renal Dose
Renal impairment: For patients undergoing chronic intermittent haemodialysis: 250 mg may be given at the start of the session, repeated after 6-12 hr, then again 36-48 hr after the initial dose, and again at the start of the next haemodialysis if >30 hr have elapsed since the previous dose.
CrCl (ml/min)
>20 500 mg every 6 hr.
5-20 250 mg every 6 hr.
<5 250 mg every 12 hr.
Contraindication
Hypersensitivity to cefradine or other cephalosporins; porphyria.
Mode of Action
Cefradine is a 1st generation cephalosporin which inhibits the final transpeptidation step of the peptidoglycan synthesis in bacterial cell wall by binding to one or more of the penicillin-binding proteins (PBPs), thus arresting cell wall synthesis leading to bacterial cell death.
Precaution
Renal impairment; history of penicillin sensitivity; pregnancy; lactation.
Side Effect
Diarrhoea, nausea, vomiting; leukopenia, neutropenia, eosinophilia, rash, pruritus; joint pain; increased BUN and creatine; dizziness.
Potentially Fatal: Pseudomembranous colitis.
Interaction
Increased risk of nephrotoxicity w/ loop diuretics. Decreased renal clearance w/ probenecid.
