ceftaroline
ceftaroline
(sef-tar-oh-leen) ceftaroline,Teflaro
(trade name)Classification
Therapeutic: anti infectivesPharmacologic: cephalosporin derivatives
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (blood levels)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
IV | rapid | end of infusion | 12 hr |
Contraindications/Precautions
Adverse Reactions/Side Effects
Gastrointestinal
- Pseudomembranous colitis (life-threatening)
- diarrhea
- nausea
Dermatologic
- rash
Hematologic
- hemolytic anemia
Local
- phlebitis at injection site
Miscellaneous
- hypersensitivity reactions including anaphylaxis (life-threatening)
Interactions
Drug-Drug interaction
None noted.Route/Dosage
Renal Impairment
Intravenous (Adults >18 yr) CCr >30 to ≤50 mL/min—400 mg every 12 hr; CCr ≥15 to ≤30 mL/min—300 mg every 12 hr; CCr <15 mL/min—200 mg every 12 hr.Availability
Nursing implications
Nursing assessment
- Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy.
- Before initiating therapy, obtain a history to determine previous use of and reactions to penicillins, cephalosporins, or carbapenems. Persons with a negative history of sensitivity may still have an allergic response.
- Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.
- Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify health care professional immediately if these symptoms occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction.
- Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several mo following cessation of therapy.
- Lab Test Considerations: May cause seroconversion from a negative to a positive direct Coombs' test. If anemia develops during or after therapy, perform a direct Coombs' test. If drug-induced hemolytic anemia is suspected, discontinue ceftaroline and provide supportive care.
Potential Nursing Diagnoses
Risk for infection (Indications, Side Effects)Diarrhea (Adverse Reactions)
Implementation
Intravenous Administration
- pH: 4.8–6.5.
- Intermittent Infusion: Reconstitute with 20 mL of sterile water for injection, 0.9% NaCl, D5W, or LR. Diluent: Dilute further with 50–250 mL of same diluent unless reconstituted with Sterile Water for Injection, then use 0.9% NaCl, D5W, D2.5W, 0.45% NaCl, or LR. Mix gently to dissolve. Solution is clear to light or dark yellow; do not administer solutions that are discolored or contain particulate matter. Solution is stable for 6 hr at room temperature or 24 hr if refrigerated.
- Rate: Infuse over 1 hr.
- Y-Site Compatibility: acyclovir, aminophylline, amiodarone, azithromycin, bumetanide, calcium chloride, calcium gluconate, ciprofloxacin, cisatracurium, clindamycin, cyclosporine, dexamethasone, digoxin, diltiazem, diphenhydramine, dopamine, doripenem, enalaprilat, esomeprazole, famotidine, fentanyl, fluconazole, furosemide, granisetron, haloperidol, heparin, hydrocortisone, hydromorphone, insulin, insulin lispro, levofloxacin, lidocaine, lorazepam, mannitol, meperidine, methylprednisolone, metoclopramide, metoprolol, metronidazole, midazolam, milrinone, morphine, moxifloxacin, multivitamins, norepinephrine, ondansetron, pantoprazole, potassium chloride, promethazine, propofol, ranitidine, remifentanil, sodium bicarbonate, trimethoprim/sulfamethoxazole, vasopressin, voriconazole
- Y-Site Incompatibility: amphotericin B colloidal, caspofungin, diazepam, filgrastim, labetalol, potassium phosphates, sodium phosphates
- Additive Incompatibility: Do not mix with other drugs or solutions.
Patient/Family Teaching
- Explain the purpose of ceftaroline to patient. Emphasize the importance of completing therapy, even if feeling better.
- Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional.
Evaluation/Desired Outcomes
- Resolution of the signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection.