Cefprozil
CEFZIL
What it isOral PBP-inhibiting second-generation cephalosporin; susceptible respiratory, ear, and skin infections.
Why this oneIt adds respiratory Gram-negative coverage beyond first-generation oral cephalosporins.
What limits itRenal impairment requires adjustment; beta-lactam allergy, diarrhea, and C. difficile remain practical concerns.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Pharyngitis/tonsillitis | Adults >=13 y | 500 mg q24h x10 days | ||
| Acute sinusitis | Adults >=13 y | 250 mg q12h x10 days | 500 mg q12h for moderate to severe infections | |
| Acute bacterial exacerbation of chronic bronchitis | Adults >=13 y | 500 mg q12h x10 days | ||
| Uncomplicated skin and skin-structure infections | Adults >=13 y | 250 mg q12h, or 500 mg q24h, or 500 mg q12h x10 days | ||
| Pharyngitis/tonsillitis | Children 2-12 y | 7.5 mg/kg q12h x10 days | Not to exceed adult doses | |
| Uncomplicated skin and skin-structure infections | Children 2-12 y | 20 mg/kg q24h x10 days | Not to exceed adult doses | |
| Otitis media | Infants/children 6 mo-12 y | 15 mg/kg q12h x10 days | Not to exceed adult doses | |
| Acute sinusitis | Infants/children 6 mo-12 y | 7.5 mg/kg q12h x10 days | 15 mg/kg q12h for moderate to severe infections | Not to exceed adult doses |
Renal CrCl 30-120 mL/min: standard dose and interval; CrCl 0-29: 50% of standard dose at standard interval; partly removed by hemodialysis — administer after completion of hemodialysis
Hepatic No adjustment needed
Instructions
- Oral
- S. pyogenes infections: treat at least 10 days
Contraindications
- Known allergy to the cephalosporin class of antibiotics
Cautions
- Colitis including pseudomembranous colitis reported (postmarketing)
- Cephalosporins have triggered seizures, particularly in renal impairment without dose reduction — discontinue if seizures occur
- Hypersensitivity reactions reported more frequently in children than adults
Adverse reactions
- Nausea 3.5%, diarrhea 2.9%, vomiting 1%, abdominal pain 1%
- Eosinophilia 2.3%; AST/ALT elevations 2%
- Genital pruritus/vaginitis 1.6%; diaper rash and superinfection 1.5%
- Rash 0.9% (more frequent in children); dizziness 1%
- Rare postmarketing: anaphylaxis, angioedema, colitis (incl. pseudomembranous), erythema multiforme, SJS, serum-sickness-like reactions, thrombocytopenia
Pregnancy Undefined
Lactation Undefined
NO BOXED WARNINGS
Principal riskNo FDA boxed warning.
Cost, est. cash$10–$300/month
Generic entry2005
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.
Mechanism of action: Cefprozil ballicule
