Cefprozil is an oral second-generation cephalosporin antibiotic like cefuroxime, cefaclor, and cefotetan that inhibits bacterial cell wall synthesis and is used to treat the following conditions:

• Treatment of mild to moderate acute bacterial exacerbations of chronic bronchitis caused by:
  •  S. pneumoniae
  • H. influenzae including beta-lactamase–producing strains
  • M. catarrhalis including beta-lactamase–producing strains.

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• Treatment of mild to moderate otitis media caused by:

  • S. pneumoniae
  • Haemophilus influenzae including beta-lactamase–producing strains
  • Moraxella (Branhamella) catarrhalis including beta-lactamase–producing strains.

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• Treatment of mild to moderate pharyngitis and tonsillitis caused by:

  •  Streptococcus pyogenes.

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• Treatment of mild to moderate uncomplicated skin and skin-structure infections caused by:

  • Staphylococcus aureus including penicillinase-producing strains
  • S. pyogenes.

Cefprozil Dose in Adults

Cefprozil Dose in Acute bacterial exacerbation of chronic bronchitis:

• 500 mg orally twice a day for 10 days.

Dose in Pharyngitis and tonsillitis:

• 500 mg orally once a day for 10 days.

Use for treatment of uncomplicated Skin and skin-structure infections:

• 250 - 500 mg orally twice a day for 10 days or
• 500 mg once a day for 10 days

Cefprozil Dose in Children

General dosing of Cefprozil in susceptible infection:

• Infants, Children, and Adolescents:
  • Mild to moderate infection:
    • 7.5 - 15 mg/kg/dose two times a day to a maximum of 500 mg/dose.

Use in treatment of acute bacterial exacerbation of Bronchitis:

• Adolescents:
  • For ten days, take 500 mg orally twice each day.

Use of Cefprozil for the treatment acute Otitis media:

• Infants older than 6 months and Children:
  • 15 mg/kg/dose orally twice a day for 10 days to a maximum of 500 mg/dose.

Use of Cefprozil for treatment of Pharyngitis and tonsillitis:

• Children older than 2 years:
  • 7.5 mg/kg/dose twice a day for 10 days to a maximum of 500 mg/dose.
• Adolescents:
  • 500 mg orally once a day for 10 days.

Use of Cefprozil for treatment of Rhinosinusitis:

• Infants older than 6 months and Children:
  • 7.5 to 15 mg/kg/dose two times a day for 10 days to a maximum of 500 mg/dose.
• Adolescents:
  • 250 - 500 mg two times a day for 10 days.

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Use of Cefprozil for treatment of Skin and soft tissue infection:

• Children 2 years of age or older:
  •  20 mg/kg/dose once a day for 10 days to a maximum of 500 mg/dose
• Adolescents:
  • 250 mg two times a day
  • 500 mg once or twice a day for 10 days.

Use of Cefprozil for treatment of Urinary tract infection:

• Infants and Children 2 - 24 months:
• 15 mg/kg/dose two times a day for 7 - 14 days

Pregnancy Risk Factor B

• It can be used by female pregnant women as there have been no adverse effects in animals.

Cefprozil use during breastfeeding

• It is found in breastmilk in small quantities. It is recommended that nursing mothers use it with caution.

Cefprozil Dose in Renal Disease:

Cefprozil dose in renal disease as per Manufacturer's recommendations:

• CrCl of more than 30 mL/minute.
  • Dose adjustment is not required.
• CrCl of less than 30 mL/minute.
  • Reduce the dose by half
• End-stage renal disease (ESRD) on hemodialysis:
  • The dose should be given after hemodialysis.

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Alternative recommendations:

• CrCl of more than 50 mL/minute:
  • Dose adjustment is not necessary.
• CrCl of less than 50 mL/minute:
  • Two times each day, administer 50% of the normal dose.
• Intermittent hemodialysis (IHD):
  • Administer supplemental dose of 250 mg after dialysis on the day of dialysis
• Peritoneal dialysis:
  • Administer half the usual dose twice daily.

Cefprozil Dose in Liver Disease:

The manufacturer has not recommended any dose adjustment in patients with liver disease.

Less Common Side Effects Of Cefprozil include:

• Central nervous system:
  • Dizziness
• Dermatologic:
  • Diaper rash
  • Genital pruritus
• Gastrointestinal:
  • Nausea
  • Diarrhea
  • Abdominal pain
  • Vomiting
• Genitourinary:
  • Vaginitis
• Hepatic:
  • Increased serum transaminases
• Infection:
  • Superinfection

Contraindication to Cefprozil include:

• Allergy or sensitivity to cefprozil, cephalosporins or any component of this formulation

Warnings and Precautions​​​​​​​

• Hypersensitivity
  • Cefprozil therapy can cause severe allergic reactions, especially for penicillin- and cephalosporin-allergic patients. If allergic reactions are detected, therapy should be stopped immediately.
• Superinfection
  • Long-term therapy for more than two months may result in superinfections, including fungal or bacterial superinfections. C. difficile-associated diarrhea, (CDAD), and pseudomembranous collitis can occur.
• Gastrointestinal Disease:
  • Patients who have had colitis in the past should not take this drug.
• Renal impairment
  • Patients with kidney disease must be cautious when using the drug. The dose should also be adjusted.

Cefprozil: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use​​​​​​​​​​​​​​

  Monitoring Parameters:

• Renal functions before the start of treatment and as needed after that
• Observe for signs of anaphylaxis during first dose.

How to take Cefprozil?

• It is administered orally without regard to meals and should be administered round the clock

Mechanism of action of Cefprozil:

• Cefprozil, a 2nd-generation antibiotic, inhibits the formation proteins and peptidoglycans.
• It binds to penicillin-binding proteins which eventually leads to cell lysis through the use of autolytic enzymes.

95% of the drug works wellabsorbed. 36% of the protein-bound population is protein-bound.bioavailability95% Half-life eliminationThe duration of the drug is 1.5 hours for infants and children, 1.3 hours for adults, 5.5 hours for patients with renal impairment, 2 hours for patients with hepatic impairment. TheTime to achieve peak serumConcentration is 1.5 hours, and 60% of drug isexcreted via urine unchanged.

International Brands of Cefprozil:

• APO-Cefprozil
• Auro-Cefprozil
• Cefzil
• RAN-Cefprozil
• SANDOZ Cefprozil
• Aprozil
• Aurozil
• Cefacura
• Cefavil
• Cefproz
• Cefrozil
• Cefzil
• Cerofazil
• Cesilpro
• Cronocef
• Lemcocef
• Lizor
• Orprozil
• Pathozil
• Procef
• Prozef
• Quzil
• Zilapro
• Zilospore
• Zilpro
• Zilroz

Cefprozil brands in Pakistan: