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cefotaxime

J01DD01

Forms & Strengths

Injectable powder for reconstitution: 500 mg, 1 g, 2 g per vial

Adult Dosing

Uncomplicated infections: 1 g IV/IM every 12 hours
Severe or life-threatening infections: 2 g IV every 4 to 8 hours
Maximum daily dose: 12 g per day
Renal impairment adjustment: CrCl < 20 mL/min, reduce normal dosage by half

Pediatric Dosing

Neonates (0-7 days): 50 mg/kg IV every 12 hours
Neonates (8-28 days): 50 mg/kg IV every 8 hours
Infants and children (1 month to 12 years, < 50 kg): 50 to 180 mg/kg/day divided every 4 to 6 hours
Severe infections/meningitis: Up to 200 mg/kg/day IV divided every 6 hours

Indications

Treatment of susceptible Gram-positive and Gram-negative bacterial infections
Lower respiratory tract infections
Urinary tract infections
Gynecological infections
Bacteremia and septicemia
Skin and skin structure infections
Intra-abdominal infections
Bacterial meningitis

Mechanism of Action

Third-generation cephalosporin bactericidal agent
Inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs)
Stable against hydrolysis by many beta-lactamases

Contraindications

Hypersensitivity to cefotaxime or other cephalosporins
History of immediate hypersensitivity reactions (e.g., anaphylaxis) to penicillins or other beta-lactams

Adverse Reactions

Injection site reactions (pain, inflammation, phlebitis)
Hypersensitivity reactions (rash, pruritus, fever, anaphylaxis)
Gastrointestinal (diarrhea, colitis including Clostridioides difficile-associated diarrhea, nausea, vomiting)
Hematologic (transient leukopenia, neutropenia, thrombocytopenia, eosinophilia)
Hepatic (transient elevations in AST, ALT, and bilirubin)

Drug Interactions

Probenecid inhibits renal excretion of cefotaxime, increasing serum concentrations
Aminoglycosides may exhibit synergistic activity but potentially increased nephrotoxicity
Loop diuretics may increase the risk of nephrotoxicity

Curated Content: Needs Vetting Before Put to Clinical Use