Cefotaxime

Indications

Cefotaxime is used for: Pneumonia, Meningitis, Peritonitis, Pelvic inflammatory disease, Endometritis, Pelvic cellulitis, Gonorrhea, Skin and skin structure infections, Respiratory tract infections, Urinary tract infections, Bacteremia/Septicemia, Bone and/or joint infections

Adult Dose

Adult: Infections Caused by Susceptible Organisms Uncomplicated: 1 g IV or IM q12hr Moderate to severe: 1-2 g IV or IM q8hr More serious (bloodstream infection [septicemia]): 2 g IV q6-8hr Life-threatening: 2 g IV q4hr; not to exceed 12 g/day Surgical prophylaxis 1 g 30-90 mins before procedure. Gonorrhoea 0.5-1 g as a single dose.

Child Dose

Children: IV, IM 50–180 mg/kg/day q6–8h 200–225 mg/kg/day for meningitis q6h Neonates: The recommended dosage is 50 mg/kg/day in 2 to 4 divided doses. In severe infections 150-200 mg/kg/day in divided doses have been given.

Renal Dose

Renal impairment: Severe: After an initial loading dose of 1 g, half the daily dose w/o changing the frequency.

Administration

IV Preparation Intermittent injection: Reconstitute 1 or 2 g with 10 mL SWI Infusion: Reconstitute infusion bottles with 50 or 100 mL NS or D5W IM: Add 2 mL, 3 mL or 5 mL of sterile or bacteriostatic water for inj to a vial

Contra Indications

Hypersensitivity to cephalosporins.

Precautions

History of penicillin allergy; colitis; impaired renal function; pregnancy, lactation. Lactation: Drug enters breast milk; use with caution

Pregnancy-Lactation

Pregnancy category: B Lactation: Drug enters breast milk; use with caution

Interactions

Probenecid decreases cefotaxime elimination. Potentially Fatal: Nephrotoxicity with furosemide and aminoglycosides.

Adverse Effects

Side effects of Cefotaxime : Colitis, Elevated blood urea nitrogen (BUN) and creatinine, Elevated hepatic transaminases, Fever. Pain at inj site; hypersensitivity reactions, rash, pruritus; diarrhoea, nausea, vomiting; candidiasis; eosinophilia, neutropenia, leucopenia, thrombocytopenia. Potentially Fatal: Anaphylactic reaction; nephrotoxicity.

Mechanism of Action

Cefotaxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.