Cefotetan Disodium and Skyla IUD

• Generic Name: cefotetan
• Dosage Forms: n.a.
• Other Brand Names: Cefotan

Treatment of bone and joint infections caused by Staphylococcus aureus.

Gynecologic Infections

Treatment of gynecologic infections caused by susceptible S. aureus (including penicillinase-producing strains), S. epidermidis, Streptococcus agalactiae (group B streptococci), other streptococci (except enterococci), Escherichia coli, Neisseria gonorrhoeae, Proteus mirabilis, Bacteroides (except B. distasonis, B. ovatus, B. thetaiotaomicron), Fusobacterium, and gram-positive anaerobic cocci (including Peptococcus and Peptostreptococcus).

Treatment of pelvic inflammatory disease (PID). Cefotetan (or cefoxitin) in conjunction with doxycycline considered a regimen of choice by CDC and others when a parenteral regimen indicated for treatment of PID. Because cefotetan (like cephalosporins) is not active against Chlamydia, concomitant use of a drug active against Chlamydia (e.g., doxycycline) is necessary when these organisms are suspected pathogens.

Intra-abdominal Infections

Treatment of intra-abdominal infections caused by susceptible Streptococcus (except enterococci), E. coli, Klebsiella (including K. pneumoniae), Bacteroides (except B. distasonis, B. ovatus, B. thetaiotaomicron), or Clostridium.

May be effective for treatment of mild to moderate infections caused by B. fragilis, but other anti-infectives (e.g., metronidazole, clindamycin) preferred, especially for severe or life-threatening infections.

IDSA states cefotetan not recommended for empiric treatment of intra-abdominal infections because of increasing prevalence of B. fragilis resistant to the drug.

Respiratory Tract Infections

Treatment of lower respiratory tract infections caused by susceptible S. pneumoniae, S. aureus (including penicillinase-producing strains), Haemophilus influenzae (including ampicillin-resistant strains), E. coli, Klebsiella (including K. pneumoniae), P. mirabilis, or Serratia marcescens.

Skin and Skin Structure Infections

Treatment of skin and skin structure infections caused by susceptible S. aureus (including penicillinase-producing strains), S. epidermidis, S. pyogenes (group A β-hemolytic streptococci), other streptococci (except enterococci), E. coli, K. pneumoniae, Peptococcus niger, or Peptostreptococcus.

Urinary Tract Infections (UTIs)

Treatment of UTIs caused by susceptible E. coli, Klebsiella (including K. pneumoniae), P. mirabilis, P. vulgaris, Providencia rettgeri, or Morganella morganii.

Should not be used alone for UTIs if Pseudomonas aeruginosa is a possible pathogen since most strains are resistant.

Perioperative Prophylaxis

Perioperative prophylaxis in women undergoing hysterectomy or cesarean section. Cefazolin, cefotetan, cefoxitin, or ampicillin and sulbactam usually recommended for women undergoing vaginal, abdominal, or laparoscopic hysterectomy; cefazolin usually recommended for women undergoing cesarean section.

Perioperative prophylaxis in patients undergoing colorectal or other GI surgery. Cefoxitin, cefotetan, cefazolin (in conjunction with metronidazole), ampicillin and sulbactam, or ertapenem usually recommended. Many clinicians recommend using both a parenteral and oral regimen (i.e., neomycin in conjunction with erythromycin or metronidazole and mechanical bowel preparation) for perioperative prophylaxis in patients undergoing colorectal surgery.

Perioperative prophylaxis in patients undergoing uncomplicated (nonperforated) appendectomy. Cefoxitin, cefotetan, or cefazolin (in conjunction with metronidazole) usually recommended for patients undergoing appendectomy.

Perioperative prophylaxis in patients undergoing biliary tract surgery. Cefazolin usually recommended for high-risk patients undergoing open biliary tract surgery; alternatives include cefotetan, cefoxitin, or ampicillin and sulbactam. Prophylaxis not considered necessary for low-risk patients undergoing elective laparoscopic cholecystectomy.

Has been used for perioperative prophylaxis in patients undergoing transurethral surgery; not usually recommended for urinary tract surgery.

• Generic Name: levonorgestrel
• Dosage Forms: intrauterine device
• Other Brand Names: Skyla, Kyleena, Liletta, Mirena, Aftera, EContra EZ, EContra One-Step, Fallback Solo, My Choice, My Way, New Day, Next Choice One Dose, Opcicon One-Step, Plan B One-Step, React, Take Action, My Way, Next Choice

Skyla contains levonorgestrel, a female hormone that can cause changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Skyla intrauterine device (IUD) is a small, flexible plastic T-shaped device. This device is placed in the uterus where it slowly releases the hormone to prevent pregnancy for 3 years. (Other types of levonorgestrel intrauterine systems release different amounts of hormone and are used for different lengths of time.)

Skyla can be used whether you have had children or not. It should not be used during pregnancy.

Levonorgestrel is a progestin hormone and does not contain estrogen. The Skyla IUD releases levonorgestrel in the uterus, but only small amounts of the hormone reach the bloodstream. Skyla should not be used as emergency birth control.