Neonatal Drug Therapy Manual


Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Cephalosporin Antibiotic
Original Date: 
January 2009
Revised Date: 
March 2022
  • Treatment of noninvasive infections due to susceptible organisms.
    • Not recommended for invasive infections (e.g meningitis, bacteremia, osteomyelitis, abscesses, pneumonia)
  • UTI prophylaxis in children with congenital antenatal hydronephrosis, high-grade vesicouretral reflux or ureterovesical junction obstruction
  • Voiding Cystourethrogram (VCUG) prophylaxis (when not on prophylaxis for UTI)
  • PO: administer on an empty stomach, or with food if GI upset occurs
Age Dose
< 7 days

50 mg/kg/day divided Q12H

Dose limit: 250 mg/day

7 - 21 days

75 mg/kg/day divided Q8H

Dose limit: 375 mg/day

> 21 days

100 mg/kg/day divided Q6H

Dose limit: 500 mg/day


UTI prophylaxis:

  •  15 mg/kg/day divided BID for neonates up to 6 weeks of age.  May give total daily dose once daily beyond 6 weeks of age. 


Voiding Cystourethrogram (VCUG) prophylaxis:(when not on prophylaxis for UTI)

  • Administer dose within 60 minutes of voiding cystourethrogram (VCUG)
    • > 35 weeks GA and < 2 weeks PNA: 25 mg/kg/dose PO x 1
    • > 35 weeks GA and > 2 weeks PNA: 50 mg/kg/dose PO x 1
    • > 35 weeks GA and > 4 weeks PNA: 75 mg/kg/dose PO x 1

Dosage adjustment required in renal impairment.  Refer to available references or clinical pharmacist for dosage adjustment.

Side Effects: 
  • GI: nausea, vomiting, diarrhea
  • Hematologic: transient neutropenia, thrombocytopenia, anemia
  • Hepatic: transient elevation in liver enzymes
Parameters to Monitor: 
  • With prolonged therapy, monitor renal, hepatic and hematologic function periodically
Reconstitution and Stability: 




The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.