세팔렉신

항생제 - 1세대 세팔로스포린Highly Important

세팔렉신은 널리 사용되는 **1세대 세팔로스포린계** 항생제입니다. 그람 양성균, 특히 **Staphylococcus pseudintermedius** 및 **Staphylococcus aureus**에 대해 높은 효과를 보여 수의 피부과, 특히 반려견의 농피증 치료에 핵심적인 역할을 합니다. * **항균 스펙트럼**: 대부분의 그람 양성 병원균(연쇄상구균, 포도상구균)에 대해 우수한 효과를 보이며, 일부 그람 음성 병원균(대장균, 클레브시엘라, 프로테우스 미라빌리스)에 대해서도 변동성 있는 효과를 나타냅니다. * **내성**: 장구균, 녹농균, 메티실린 내성 포도상구균(MRSA/MRSP) 및 Bacteroides fragilis에는 일반적으로 효과가 없습니다. * **임상 요점**: 세팔렉신은 **시간 의존성** 항생제로, 감염 부위에서 약물 농도가 최소억제농도(MIC) 이상으로 유지되는 시간에 따라 효능이 결정됩니다. 개와 고양이에서는 경구 투여 시 내약성이 좋으나, 말에서는 경구 생체이용률이 매우 낮습니다.

작용 기전: Cephalexin is a **bactericidal** antibiotic that disrupts bacterial cell wall synthesis. * **Mechanism**: It binds to specific enzymes known as **penicillin-binding proteins (PBPs)** (e.g., transpeptidases, carboxypeptidases) located on the inner surface of the bacterial cell membrane. * **Pathway**: Binding to PBPs → Inhibition of the final transpeptidation step of peptidoglycan synthesis → Formation of a defective, osmotically unstable cell wall (spheroplast) → **Cell lysis and death**. * Like other beta-lactams, it is most effective against actively dividing bacteria.

동물 종별 용량

Dogs

For superficial and deep pyoderma · 22-33 mg/kg PO two to three times daily · PO · q8-12h · 5-7 days beyond resolution
For recurrent pyoderma · 22 mg/kg PO q12h (use at q8h for deep pyoderma) · PO · q8-12h · 5-7 days beyond resolution
For superficial canine pyoderma · 30-40 mg/kg PO once daily (q24h) for 4 weeks. · PO · q24h · 4 weeks
For pyoderma · 22-35 mg/kg PO q12h or 22 mg/kg PO q8h · PO · q8-12h · 5-7 days beyond resolution
For respiratory infections · 20-40 mg/kg PO q8h · PO · q8h · 5-7 days beyond resolution
For soft tissue infections · 30-50 mg/kg PO q12h · PO · q12h · 5-7 days beyond resolution
For systemic infections · 25-60 mg/kg PO q8h · PO · q8h · 5-7 days beyond resolution
For orthopedic infections · 22-30 mg/kg PO q6-8h for 28 days · PO · q6-8h · 28 days
For pyometra/metritis · 10-30 mg/kg PO q8-12h · PO · q8-12h
For UTI · 30-40 mg/kg PO q8h. · PO · q8h · 7-10 days for acute; up to 4-8 weeks for chronic/pyelonephritis
For neonates · 10-30 mg/kg PO twice daily-three times daily · PO · q8-12h · Weak neonates should be given via stomach tube

투여 경로

POIM (outside USA)SC (outside USA)

금기

Known hypersensitivity to cephalosporins
Patients with septicemia, shock, or grave illness (oral absorption is unreliable; parenteral routes preferred)

이상반응

Gastrointestinal upset (anorexia, vomiting, diarrhea)
Hypersensitivity reactions (rashes, fever, eosinophilia, anaphylaxis)
Salivation, tachypnea, and excitability (reported in dogs)
Emesis and fever (reported in cats)
Nephrotoxicity (rare)
Toxic epidermal necrolysis (rarely reported in cats)
Antibiotic-associated diarrhea or gut flora alteration

약물 상호작용

Probenecid · Competitively blocks the tubular secretion of cephalosporins, thereby increasing serum levels and prolonging serum half-lives.
Aminoglycosides · Increased risk of nephrotoxicity. Do not mix in the same syringe. · major
Amphotericin B · Increased risk of nephrotoxicity. · major
Loop diuretics (e.g., furosemide) · Increased risk of nephrotoxicity. · moderate

모니터링

Clinical efficacy (resolution of clinical signs and negative cultures)
Renal function (BUN, creatinine, urinalysis) in patients with pre-existing renal disease or those on concurrent nephrotoxic drugs

과용량

Acute oral cephalosporin overdoses are unlikely to cause significant problems other than **gastrointestinal distress** (vomiting, diarrhea, anorexia). * **Severe Overdose**: Extremely high doses or very prolonged use has been associated with neurotoxicity, neutropenia, agranulocytosis, thrombocytopenia, hepatitis, interstitial nephritis, and tubular necrosis. * **Treatment**: Treatment is generally supportive and symptomatic. Emptying the gut may be considered for massive recent ingestions.

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