Cefotaxime

Cephalosporin · Cephalosporin

Indications

Infections of the respiratory tract, kidney, urinary tract and reproductive organs, including gonorrhoea, septicaemia, endocarditis, meningitis. Infections of bone, joint, soft tissues and skin. Abdominal infections, infections of ear and throat. Infected burns and wounds. Infections in gynaecology and obstetrics. For treatment or prophylaxis of in patients with reduced resistance (dose and number of infections depend on the clinical picture and the local resistance situation).

Dosage

Adults: 1 gm IV or IM every 12 hr; serious infections, 3-6 gm daily in three or four divided doses; max 12 gm daily. Use 2 gm by IV route. Children: Neonates, 50 mg/kg daily; others, 100-150 mg/kg daily. Both in two to four divided doses; max 200 mg/kg daily. Bone Infection: IM/IV: Adults & Children: >50 kg: 1-2 gm every 8 hr. Max: 12 gm/day. Children: 1 mth-12 yr: <50 kg: 50-180 mg/kg/day divided into 4-6 doses. 1-4 wk: 50 mg/kg IV every 8 hr. 0-1 wk: 50 mg/kg IV every 12 hr. Meningitis: IV: Adults & Children: >50 kg: 2 gm every 6-8 hr. Max: 12 gm/day. Children: 1 mth-12 yr: <50 kg: 50-180 mg/kg/day divided into 4-6 doses. 1-4 wk: 50 mg/kg IV every 8 hr. 0-1 wk: 50 mg/kg IV every 12 hr. Septicaemia: IV: Adults & Children: >50 kg: 2 gm every 4 hr. Max: 12 gm/day. Children: 1 mth-12 yr: <50 kg: 50-180 mg/kg/day divided into 4-6 doses. 1-4 wk: 50 mg/kg IV every 8 hr. 0-1 wk: 50 mg/kg IV…

Administration

IM: Inject deep IM into large muscle mass. IV: Inject direct IV over 3-5 min. Infuse intermittent infusion over 30 min. Reconstitution: IV: Reconstitute each 0.5, 1, or 2 gm vial with 10 mL of SWFI. Shake to dissolve. For intermittent IV infusion, further dilute in 50-100 mL of D5W or NS. IM: Reconstitute each 500 mg vial with 2 mL SWFI or bacteriostatic water for injection, each 1 gm vial with 3 mL diluent and each 2 gm vial with 5 mL diluent. Shake to dissolve. Compatibility: D5 1/4 NS, D5 ½ NS, D5NS, D5W, D10W, LR, NS. Stability: Reconstituted solution is stable for 12-34 hours at room temperature and 7-10 days when refrigerated and for 13 weeks when frozen. For IV infusion NS or D5W solution is stable for 24 hours at room temperature, 5 days when refrigerated.

Adverse Effects

Pain at inj site, phlebitis, hypersensitivity reactions. GI upset, candidiasis, eosinophilia, neutropenia, leucopenia, granulocytopenia, agranulocytosis, thrombocytopenia, haemolytic anaemia, raised liver enzymes. Rarely, pseudomembranous colitis. Risk of encephalopathy and changes in renal function with high doses. Positive Coomb's test.

Risk Factor (Pregnancy/Lactation)

Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Precautions: Penicillin sensitivity. Severe renal failure. Monitor blood count if treatment exceeds 10 days.

Interactions

Loop diuretics, aminoglycosides, probenecid.

Advice to Patient

Contact prescriber if there is burning/swelling/redness/pain at injection or infusion site or rash, hives, itching, difficulty in breathing or swallowing, severe unrelieved diarrhoea, vaginal drainage or itching, mouth sores, blood/pus/mucus in stool or urine, unusual chills or fever occur. Watery or bloody stools can occur 2 or more months after therapy and can be serious, requiring immediate treatment. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber.

Pharmacokinetics

Metabolism: Partially hepatic to active metabolite, desacetylcefotaxime. Half-life elimination: Cefotaxime: Infants <1500 gm: 4.6 hrs. Infants >1500 gm: 3.4 hrs. Children: 1.5 hrs. Adults: 1-1.5 hrs; prolonged with renal and/or hepatic impairment. Desacetylcefotaxime: 1.3-1.9 hrs; prolonged with renal impairment. Time to peak, serum: IM: Within 30 mins. Excretion: Urine.

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

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