Ostermayer: Created page with "==General== Type: Is Generation::2nd generation Is DrugClass::Carbacephem Dosage Forms: Capsule, Powder for oral suspension Dosage Strengths: 200mg, 400mg; 100mg/5mL, 200mg/5mL Routes of Administration: PO Common Trade Names: Lorabid ==Adult Dosing== ===General=== See specific indications below Take on an empty stomach (1 hour before or 2 hours after food) Max: Not established, typically 800mg/day ===UTI, Uncomplicated (Cystitis)=== *200mg PO q24h x..."

2026-01-28T19:07:40Z

Created page with "==General== *Type: Is Generation::2nd generation Is DrugClass::Carbacephem *Dosage Forms: Capsule, Powder for oral suspension *Dosage Strengths: 200mg, 400mg; 100mg/5mL, 200mg/5mL *Routes of Administration: PO *Common Trade Names: Lorabid ==Adult Dosing== ===General=== *See specific indications below *Take on an empty stomach (1 hour before or 2 hours after food) *Max: Not established, typically 800mg/day ===UTI, Uncomplicated (Cystitis)=== *200mg PO q24h x..."

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==General==
*Type: [[Is Generation::2nd generation]] [[Is DrugClass::Carbacephem]]
*Dosage Forms: Capsule, Powder for oral suspension
*Dosage Strengths: 200mg, 400mg; 100mg/5mL, 200mg/5mL
*Routes of Administration: PO
*Common Trade Names: Lorabid

==Adult Dosing==
===General===
*See specific indications below
*Take on an empty stomach (1 hour before or 2 hours after food)
*Max: Not established, typically 800mg/day

===[[UTI]], Uncomplicated (Cystitis)===
*200mg PO q24h x 7 days

===[[Pyelonephritis]], Uncomplicated===
*400mg PO q12h x 14 days

===Acute Bacterial Exacerbation of Chronic [[Bronchitis]]===
*400mg PO q12h x 7 days

===Community Acquired [[Pneumonia]]===
*400mg PO q12h x 14 days

===[[Sinusitis]], Acute===
*400mg PO q12h x 10 days

==Pediatric Dosing==
===General (6 months - 12 years)===
*Acute [[Otitis Media]]: 30mg/kg/day PO divided q12h x 10 days
*Acute Maxillary [[Sinusitis]]: 30mg/kg/day PO divided q12h x 10 days
*Pharyngitis/Tonsillitis: 15mg/kg/day PO divided q12h x 10 days (Strep. pyogenes)
*Impetigo: 15mg/kg/day PO divided q12h x 7 days
*Do not use in infants < 6 months

==Special Populations==
*Pregnancy: B
*Lactation: Excreted in breast milk; use with caution
*Renal
**Adult
***CrCl >= 50: Standard dose
***CrCl 10-49: 50% of recommended dose at usual interval
***CrCl <10: Recommended dose given every 3 to 5 days
***Hemodialysis: Give supplemental dose following dialysis
**Pediatric
***Clinical data limited; follow adult adjustments based on GFR
*Hepatic
**No adjustment necessary

==Contraindications==
*Allergy to class/drug (Carbacephem or Cephalosporin)
*Documented anaphylaxis to Penicillin (cross-reactivity exists)

==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*[[Clostridium difficile]] associated diarrhea
*[[Seizures]]
*Renal dysfunction

===Common===
*[[Diarrhea]]
*[[Nausea and Vomiting]]
*[[Headache]]
*[[Abdominal Pain]]
*[[Rash]] (Higher incidence in pediatric patients)
*Rhinitis
*Vaginitis

==Pharmacology==
*Half-life: ~1 hour
*Metabolism: Not metabolized
*Excretion: Urine (unchanged drug)
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis. Chemically a carbacephem (carbon replaces sulfur in dihydrothiazine ring) but biologically acts as a second-generation cephalosporin.

==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||I
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||X1
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[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]]||X1
|-
| ||[[Francisella tularensis]]||R
|-
| ||[[Brucella sp.]]||R
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||R
|-
| ||[[Mycobacterium avium]]||R
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||I
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||X1
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}

===Key===
{{Template:Antibacterial Spectra Key}}

==See Also==
*[[Antibiotics (Main)]]

==References==
<references/>

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

Carbacephem - Revision history