Cefotaxime
Mechanism :
Cefotaxime is a semisynthetic, broad spectrum cephalosporin antibiotic for parenteral administration. Cephalosporins are bactericidal because of their inhibition of cell-wall synthesis.
Indication :
- Pneumonia
- Meningitis
- Epiglottitis
- Pyoderma
- Pyelonephritis
- Subcutaneous abscess
- Pelvic infections
- Peritonitis
Contraindications :
Cefotaxime is contraindicated in patients with known allergy to the cephalosporin group of antibiotics.
Dosing :
<12 years or <50 kg:
50-200 mg/kg/day IV/IM in 6-8 hourly divided doses for 7-14 days. For severe infections, meningitis use the dose of 200 mg/kg/day.
>12 years or >50 kg:
1-2 g IV/IM every 8 hours for 7-14 days. For severe infections, meningitis use the dose of 2 g/day.
Adverse Effect :
Injection site inflammation, hypersensitivity (rash, pruritus, fever, urticaria and anaphylaxis), colitis, diarrhea, nausea, and vomiting, pseudomembranous colitis.
Interaction :
Aminoglycoside: Increased nephrotoxicity has been reported following concomitant administration of cephalosporins and aminoglycoside antibiotics.
Positive direct Coombs tests have been reported during treatment with the cephalosporin antibiotics.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | 1 g every 8–12 hours |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Dialysed. Dose as in GFR<10 mL/ min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
| CAV/VVHD | Dialysed. 1–2 g every 12 hours |
| CVVHD/HDF | Dialysed. 2 g every 12 hours |
Hepatic Dose :
No dosage adjustments are recommended.