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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › OTHER BETA-LACTAM ANTIBACTERIALS › Second-generation cephalosporins
cefotetan
J01DC05
Forms & Strengths
- Injectable powder for reconstitution: 1 g
- Injectable powder for reconstitution: 2 g
- Pharmacy bulk package: 10 g
Adult Dosing
- General infections: 1 to 2 g IV or IM every 12 hours for 5 to 10 days
- Surgical prophylaxis: 1 to 2 g IV single dose administered 30 to 60 minutes prior to surgery
Pediatric Dosing
- Neonates (safety and efficacy not established)
- Pediatric patients: 40 to 80 mg/kg/day IV divided every 12 hours
Indications
- Urinary tract infections caused by susceptible Gram-negative bacilli
- Lower respiratory tract infections caused by Streptococcus pneumoniae, Staphylococcus aureus, and Gram-negative bacilli
- Skin and skin structure infections
- Gynecologic infections including endometritis and pelvic inflammatory disease
- Intra-abdominal infections
- Surgical prophylaxis in colorectal, hysterectomy, and cesarean section procedures
Mechanism of Action
- Second-generation cephalosporin bactericidal antibiotic
- Inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs)
- Possesses a 3-methylthiotetrazole (MTT) side chain associated with hypoprothrombinemia and disulfiram-like reactions
Contraindications
- Known hypersensitivity to cefotetan or other cephalosporin-class antibiotics
- History of cephalosporin-associated anaphylactic reactions
Adverse Reactions
- Diarrhea and pseudomembranous colitis
- Hypersensitivity reactions including rash, pruritus, urticaria, and anaphylaxis
- Hematologic abnormalities including hypoprothrombinemia, bleeding disorders, positive direct Coombs' test, and thrombocytopenia
- Gastrointestinal effects including nausea and vomiting
- Transient elevation of liver enzymes and BUN/creatinine
- Injection site reactions including pain and phlebitis
Drug Interactions
- Alcohol: Disulfiram-like reaction (flushing, tachycardia, nausea, vomiting) up to 72 hours after administration
- Anticoagulants (warfarin, heparin): Increased risk of bleeding due to hypoprothrombinemia and inhibition of vitamin K synthesis
- Nephrotoxic drugs (aminoglycosides, loop diuretics): Increased risk of nephrotoxicity
- Probenecid: Decreases renal tubular secretion of cefotetan, resulting in increased serum concentrations
Curated Content: Needs Vetting Before Put to Clinical Use