Usual Adult Dose for Bronchitis

500 mg orally every 12 hours for 10 days

Usual Adult Dose for Cystitis

500 mg orally every 24 hours for 3 to 7 days

Usual Adult Dose for Otitis Media

500 mg orally every 24 hours for 5 to 10 days

Usual Adult Dose for Pneumonia

Community-acquired pneumonia, nonhospitalized patients: 500 mg orally every 12 hours for 7 to 21 days, depending on the nature and severity of the pneumonia

Usual Adult Dose for Pyelonephritis

Uncomplicated: 500 mg orally every 12 to 24 hours for 14 days

Usual Adult Dose for Sinusitis

250 to 500 mg orally every 12 hours for 10 days

Usual Adult Dose for Skin or Soft Tissue Infection

250 to 500 mg orally every 12 hours for 10 days or 500 mg orally every 24 hours for 10 days

Usual Adult Dose for Tonsillitis/Pharyngitis

500 mg orally every 24 hours for 10 days

Usual Adult Dose for Upper Respiratory Tract Infection

500 mg orally every 12 to 24 hours for 10 to 14 days

Usual Pediatric Dose for Otitis Media

6 months to 12 years: 15 mg/kg orally every 12 hours for 10 days; do not exceed 1 g/day
13 years or older: Adult dose

Usual Pediatric Dose for Sinusitis

2 to 12 years: 7.5 to 15 mg/kg orally every 12 hours for 10 days; do not exceed 1 g/day
13 years or older: Adult dose

Usual Pediatric Dose for Skin or Soft Tissue Infection

2 to 12 years: 20 mg/kg orally every 24 hours for 10 days; do not exceed 1 g/day
13 years or older: Adult dose

Usual Pediatric Dose for Tonsillitis/Pharyngitis

2 to 12 years: 7.5 mg/kg orally every 12 hours for 10 days; do not exceed 1 g/day
13 years or older: Adult dose

Renal Dose Adjustments

CrCl 29 mL/min or less: The dose should be 50% of the standard dose at the same dosing interval and duration.

Liver Dose Adjustments

No adjustment recommended

Precautions

Clostridium difficile associated diarrhea (CDAD) has been reported with almost all antibiotics and may potentially be life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea following cephalosporin therapy. Mild cases generally improve with discontinuation of the drug, while severe cases may require supportive therapy and treatment with an antimicrobial agent effective against C difficile. Hypertoxin producing strains of C difficile cause increased morbidity and mortality; these infections can be resistant to antimicrobial treatment and may necessitate colectomy.

Cephalosporins may be associated with a fall in prothrombin activity. Risk factors include renal or hepatic impairment, poor nutritional state, a protracted course of antimicrobial therapy, and chronic anticoagulation therapy. Prothrombin times should be monitored and vitamin K therapy initiated if indicated.

Serious and occasionally fatal hypersensitivity reactions have been reported with antibiotics. The drug should be discontinued immediately at the first appearance of a skin rash or other signs of hypersensitivity. Severe, acute hypersensitivity reactions may require treatment with epinephrine and other resuscitative measures including oxygen, intravenous fluids, antihistamines, corticosteroids, cardiovascular support and airway management as clinically indicated.

Some cephalosporins have been associated with seizures in renally impaired patients with elevated serum concentrations. The drug should be discontinued if seizures occur. Nephrotoxicity has occurred with concomitant cephalosporins and aminoglycosides or potent diuretics. Renal function should be monitored, especially in elderly patients.

Phenylketonuric patients should be aware that cefprozil suspension contains phenylalanine 28 mg per teaspoon.

Dialysis

Cefprozil is in part removed by hemodialysis. The dose should be administered after the completion of hemodialysis.