Generic Name Cephalothin Sodium

Brand Name Keflin

Drug Classification  first-generation cephalosporin
antibiotic
Mechanism of Action The in vitro bactericidal action of cefalotin
results from inhibition of cell wall
synthesis. In general, cefalotin has higher
activity against Gram-positive than Gram-
negative organisms. Gram-negative
organisms vary greatly in their sensitivity
to the drug. Susceptibility testing is highly
desirable because the range of antibiotic
concentrations at which bacteria are
inhibited may vary substantially according
to the isolate.
Cefalotin is usually active against the
following organisms in vitro: beta
haemolytic and other Streptococci (most
strains of Enterococci, e.g. Enterococcus
faecalis, are resistant); Staphylococci
(including coagulase-positive, coagulase-
negative, and penicillinase producing
strains), methicillin resistant
Staphylococci are resistant;
Streptococcus pneumoniae; Haemophilus
influenzae; Escherichia coli; Klebsiella;
Proteus mirabilis.
Dosage Adult
 2 g administered intravenously just
prior to surgery (approximately half to
one hour before the initial incision); 2
g during surgery (administration
 modified according to the duration of
the operative procedure); and 2 g
every six hours post-operatively for
24 hours.
Children
 20 to 30 mg/kg may be given at the
times designated above.
 Since cefalotin has a serum half life
of 30 to 50 minutes, it is important
that the pre-operative dose be given
just prior to the start of surgery so
that adequate antibiotic levels are
present in the serum and tissues at
the time of initial surgical incision; and
that cefalotin be administered (only if
necessary) at appropriate intervals
during surgery to provide sufficient
levels of the antibiotic at the
anticipated moments of greatest
exposure to infective organisms.

Indications Respiratory tract

 Infections caused by S. pneumoniae,
Staphylococci (penicillinase and
nonpenicillinase producing), group A
beta haemolytic Streptococci,
Klebsiella, and H. influenzae.
Skin and soft tissue
 Infections, including peritonitis,
caused by Staphylococci
(penicillinase and nonpenicillinase
producing), group A beta haemolytic
Streptococci, E. coli, P. mirabilis, and
Klebsiella.
Genitourinary tract
 Infections caused by E. coli, P.
mirabilis and Klebsiella.
Septicaemia, including endocarditis.
 Infections caused by S. pneumoniae,
Staphylococci (penicillinase and
nonpenicillinase producing), group A
beta haemolytic Streptococci, S.
viridans, E. coli, P. mirabilis, and
Klebsiella.
Bone and joint
 Infection caused by Staphylococci
 (penicillinase and nonpenicillinase
producing).
 Prophylactically in vaginal
hysterectomy, head and neck
surgery, insertion of prosthetic heart
valves, and prosthetic arthroplasty.
Cefalotin is not recommended for
gastrointestinal procedures or other
sites where anaerobic organisms
such as Bacteroides tend to prevail.
Dosage is required pre-, intra- and
post-operatively
Contraindications  Keflin is contraindicated in persons
who have shown hypersensitivity to
the cephalosporin group of antibiotics
or who have previously experienced a
major allergy to penicillin
Side Effects Common side effects
 pain, swelling or red skin at the
injection site
 diarrhea.
Severe side effects
 watery and severe diarrhoea, which
may also be bloody
 severe chills, sore throat or mouth
ulcers
 skin problems such as rash or
itchiness
 bruising more easily than normal
 signs of anaemia, such as tiredness,
being short of breath and looking pale
 jaundice
 swelling of the face, lips, mouth or
throat which may cause difficulty in
swallowing or breathing
Adverse Reactions Hypersensitivity
 Maculopapular rash, urticaria,
reactions resembling serum sickness
and anaphylaxis
Blood
 Several instances of neutropenia in
patients receiving Keflin have been
reported
Gastrointestinal
 As with some other antibiotics, colitis,
including rare instances of
 pseudomembranous colitis, has been
reported in conjunction with therapy
with Keflin. Nausea and vomiting
have been reported rarely
Liver
 Transient rise in AST and alkaline
phosphatase
Kidney
 Rise in BUN and decreased
creatinine clearance have been
reported, particularly in patients with
prior renal impairment
Local Reactions
 Pain, induration, tenderness and
elevation of temperature have been
reported following repeated
intramuscular injections
Drug Interaction Drug: May increase concentration and
toxicity
 Lasix (furosemide)
 aminoglycoside antibiotics
 Oral anticoagulants
Food: None
Nursing Responsibilities Wash hands
R: Prevent the spread of microorganisms

Check culture and sensitivity reports

R:to ensure that this is the drug of choice
for this patient.

Enquire the complete health history of the

patient including allergy and drug
interactions
R: This allows for the patient to receive
proper care while considering their
previous or underlying conditions

Supervise for seizures

R: The administration of inappropriately
large doses of parenteral cephalosporins
may cause seizures, particularly in
patients with renal impairment

Monitor daily pattern of

bowel activity, stool consistency
R: Regular monitoring with stool chart
 prevents constipation, urinary retention
and delirium in patients.

Avoid alcohol consumption

R: Mixing alcohol with certain medications
can cause nausea and vomiting,
headaches, drowsiness, fainting, or loss
of coordination. It also can put you at risk
for internal bleeding, heart problems, and
difficulties in breathing

Advise the client to take oral doses with

at least 8 oz of water
R: This is to prevent esophageal irritation.

Educate patient and family to report if any

symptoms appear such as: difficulty
breathing, severe headache, fever,
diarrhea, and signs of infection
R: To prevent further complications

Continue therapy for full length of

treatment
R: Skipping doses or not completing the
full course of therapy may decrease the
effectiveness of the immediate treatment.

Educate client on drug therapy

R:to promote understanding and
compliance.

Instruct patient and family to do not

abruptly discontinue medication
R: Discontinuing a medication abruptly
can often be associated with unpleasant
side effects and worsening of symptoms
based on your drug treatment, its
chemistry profile, and how your drug is
broken down and excreted from your
body

References
Doctors Alert. (2017, May 13). Cephalothin (Cefalotin) : Therapeutic uses, Dosage & Side Effects.
DoctorAlerts. Retrieved May 11, 2022, from https://www.doctoralerts.com/cephalothin-cefalotin/
NPS MEDICINEWISE. (2018, May 1). Keflin Neutral Powder for injection - Medicine. NPS
MedicineWise. Retrieved May 11, 2022, from https://www.nps.org.au/medicine-finder/keflin-
neutral-powder-for-injection
NPS MEDICINEWISE. (2019, June 1). DBL Cephalothin Sodium for Injection - Cefalotin. NPS
MedicineWise. Retrieved May 11, 2022, from https://www.nps.org.au/medicine-finder/dbl-
cephalothin-sodium-for-injection-powder-for-injection#4.5-interactions-with-other-medicines-
and-other-forms-of-interactions
Tabangcora, I. D. (2022, May 3). Antibiotics: Nursing Pharmacology Study Guide. Nurseslabs.
Retrieved May 11, 2022, from https://nurseslabs.com/antibiotics/#interactions-3