Cefpirome

Intravenous
Susceptible infections

Loading dose: 1-2 g followed by a maintenance dose adjusted according to CrCl.

CrCl	Dosage
<5 (in haemodialysis patients)	0.5 or 1 g once daily with half-dose after each dialysis session.
20-50	0.5-1 g bid.
5-20	0.5-1 g once daily.

Hypersensitivity; porphyria.

Allergy to penicillin or to cephalosporins; renal impairment, monitor renal and haematological status; pregnancy and lactation.

Rash, pruritus, urticaria; nausea, vomiting, abdominal pain, diarrhoea; increased plasma levels of ASAT, ALAT, gamma-GT, LDH, bilirubin and/or alkaline phosphatase; interstitial nephritis, acute renal failure; thrombocytopaenia, eosinophilia, haemolytic anaemia, neutropaenia, agranulocytosis; thrombophloebitis, pain at Inj site; convulsions, fever; haemorrhage.
Potentially Fatal: Pseudomembranous colitis.

Reduced clearance with probenecid.

Interferes with Jaffe method of creatinine conc measurement in determining renal function.

Description: Cefpirome binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Pharmacokinetics:
Distribution: Widely distributed into body tissues and fluids; enters breast milk. Protein-binding: 10%
Excretion: Mainly by the kidneys via the urine (80-90% as unchanged); significantly removed by haemodialysis; 2 hrs (elimination half-life); prolonged in renal impairment.

Store below 25°C.

Cephalosporins