For general information on the cephalosporins including adverse effects, contraindications, overdosage, drug interactions, and monitoring parameters, refer to the monograph: Cephalosporins, General Information.
Chemistry - Ceftiofur sodium and HCl are semisynthetic 3rd generation cephalosporins.
Storage/Stability/Compatibility - Unreconstituted ceftiofur sodium powder for reconstitution should be stored in the refrigerator (2°-8°C). Protect from light. Color of the cake may vary from off-white to tan, but this does not affect potency. After reconstitution with bacteriostatic water for injection or sterile water for injection, the solution is stable for up to 7 days when refrigerated and for 12 hours at room temperature (15-30°C). According to the manufacturer, if a precipitate should form while being stored refrigerated during this time, the product may be used if it goes back into solution after warming. If not, contact the manufacturer. Frozen reconstituted solutions are stable for up to 8 weeks. Thawing may be done at room temperature or by swirling the vial under running warm or hot water.
The HCl product should be stored at controlled room temperature (20°-25°C; 68°-77°F) and protected from freezing. It should be shaken well before use.
Pharmacology/Spectrum of Activity - Ceftiofur inhibits cell wall synthesis (at stage three) of susceptible multiplying bacteria. Ceftiofur exhibits a spectrum of activity similar to that of cefotaxime. It has a broad range of in vitro activity against a variety of pathogens, including many species of Pasturella, Streptococcus, Staphylococcus, Salmonella, and E.coli.
Uses/Indications - Ceftiofur sodium/HCl is indicated for treatment of bovine respiratory disease (shipping fever, pneumonia) associated with Pasturella hemolytica, Pasturella multocida and Haemophilus somnus in lactating or non-lactating cattle and ceftiofur sodium is indicated in horses for respiratory disease associated with Strep zooepidimicus:. Ceftiofur HCl is also approved for foot rot in cattle.
Ceftiofur could potentially be of usefulness in small animal infections as well, but little published data is available to recommend its use.
Pharmacokinetics (specific) - In cattle, ceftiofur sodium and HCl have practically equivalent pharmacokinetic parameters. Peak levels of ceftiofur are slightly higher after IM injection of Naxcel®, but areas under the curve are practically equal as well as elimination half-lives (approx. 9-12 hours).
For labeled indications:
a) Naxcel®: 1.1 - 2.2 mg/kg IM once daily for 3 treatments; may give additional doses on 4th and 5th day if response is not satisfactory. Reconstitute 1 g vial with 20 ml and the 4 g vial with 80 ml of either Bacteriostatic Water for Injection or Sterile Water for Injection. (Package Insert; Naxcel®—Upjohn)
b) Excenel®: 1.1 - 2.2 mg/kg IM or SQ once daily for 3 treatments; may give additional doses on 4th and 5th day if response is not satisfactory. For BRD only: May inject 2.2 mg/kg IM or SQ every other day (days 1 and 3; 48 hour interval). Do not inject more than 15 ml pe IM injection site. (Package Insert; Excenel ®—Pharmacia/Upjohn)
For respiratory disease associated with Strep zooepidimicus::
a) Naxcel®: 2.2 - 4.4 mg/kg (2 - 4 ml reconstituted sterile solution per 100 lb. of body weight) with a maximum of 10 ml administered per injection site. Repeat treatment at 24 hour intervals, continued for 48 hours after symptoms have disappeared. Do not exceed 10 days of treatment. (Package Insert; Naxcel®—Upjohn)
a) 2.2 – 4.4 mg/kg (Houck, 1986)
b) 1.1 mg/kg IM (Schmidt, 1986)
c) Naxcel can be reconstituted with less diluent than the package recommendations (25 to 35 ml vs 80 ml) and injections are well-tolerated (Mikota, 2003).
d) 1.1 mg/kg IM BID or TID or 1.1 mg/kg IV SID depending on the MIC of the pathogen (Dumonceaux, 2005).
e) See also Cephalosporins (General Information)
a) Houck, R: Senior Veterinarian, Ringling Brothers and Barnum and Bailey Circus, 8607 Westwood Center Drive, Vienna, Virginia, 22182, personal communication, 1986. In: Olsen,J.H., 1999. Antibiotic therapy in elephants. In: Fowler,M.E. and Miller R.E. (Editors), Zoo and Wild Animal Medicine: Current Therapy 4. W.B. Saunders,
Philadelphia, PA,USA p. 538
b) Schmidt, M.J: Senior Research Veterinarian, Washington Park Zoo, Portland, Oregon, personal communication, 1986. In: Olsen,J.H., 1999. Antibiotic therapy in elephants. In: Fowler,M.E. and Miller R.E. (Editors), Zoo and Wild Animal Medicine: Current Therapy 4. W.B. Saunders, Philadelphia, PA,USA p. 538
c) Author’s (Mikota) experience.
d) Dumonceaux, G, Isaza, R. Koch, D.E.,
and Hunter, R.P. 2005. Pharmacokinetics and i.m. bioavailability of
ceftiofur in Asian elephants (Elephas maximus). J Vet Pharmacol Ther.
Dosage Forms/Preparations/FDA Approval Status/Withholding Times -
Ceftiofur Sodium Powder for Injection 1 g, 4 g vials; Naxcel® (Pharmacia&Upjohn); (Rx) Approved for use in cattle and horses. No slaughter withdrawal or milk withholding time are required when administered as labeled.
Ceftiofur HCl Suspension for Injection 50 mg(of ceftiofur)/ml in 100 ml vials; Excenel® (Pharmacia&Upjohn); (Rx). Approved for use in cattle. Slaughter withdrawal=48 hours; no milk withholding time required when administered as labeled.
Human-Approved Products: None
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