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Cefotaxime information from DrugsUpdate  

See Available Brands of Cefotaxime in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Cefotaxime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram positive and Gram negative bacteria. In most cases, it is considered to be equivalent to ceftriaxone in terms of safety and efficacy. Cefotaxime sodium is marketed under various trade names including Claforan (Roussel-Uclaf)& Taxim (Alkem Laboratories)

Pharmacodynamics

Pharmacokinetics

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.
Absorption: Rapidly absorbed (IM); peak plasma concentrations after 30 min (IM), 4 hr (IV).
Distribution: Widely distributed into body tissues and fluids; CSF (therapeutic concentrations, esp when the meninges are inflamed). Crosses the placenta and enters breast milk. Protein-binding: 40%.
Metabolism: Hepatic (partial); converted to desacetylcefotaxime and inactive metabolites.
Excretion: Mainly by the kidneys via the urine (40% as unchanged drug within 24 hr); further 20% as desacetylcefotaxime. Removed by haemodialysis.


 

Cefotaxime Indications / Cefotaxime Uses

Information Not Available

Cefotaxime Adverse Reactions / Cefotaxime Side Effects

Pain at inj site; hypersensitivity reactions, rash, pruritus; diarrhoea, nausea, vomiting; candidiasis; eosinophilia, neutropenia, leucopenia, thrombocytopenia.
Potentially Fatal: Anaphylactic reaction; nephrotoxicity.

Precautions

Information Not Available

Special Precautions

History of penicillin allergy; colitis; impaired renal function; pregnancy, lactation.

Other Drug Interactions

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

Other Interactions

Information Not Available

Dosage

Parenteral
Bacteraemia
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Endometritis
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Gonorrhoea
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Gynaecological and obstetrical infections
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Infections in immunocompromised patients
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Infections with multi-resistant pathogens
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Septicaemia
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Meningitis
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Intra-abdominal infections
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Urinary tract infections
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Ventriculitis
Adult: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes. Max: 12 g daily.
Child: ≤1 mth: 50 mg/kg/dose, given every 8-12 hr; 1 mth-12 yr and <50 kg: 50-180 mg/kg/day, given in 4-6 equally divided doses. Higher doses may be used in more severe infections. ≥50 kg: 1-2 g every 4-12 hr depending on the severity of the infection. May be given via deep IM inj or slow IV inj over 3-5 minutes or by IV infusion over 20-60 minutes.
Max Dosage: Adult: 12 g.
Renal impairment: Dose reduction is necessary.
Parenteral
Surgical prophylaxis
Adult: 1 g, given 30-90 minutes before surgery. May be given via IM or IV inj or infusion.
Renal impairment: Dose reduction is necessary.
Parenteral
Gonorrhoea
Adult: A single dose of 0.5-1 g, given via IM inj or slow IV inj or infusion.
Renal impairment: Dose reduction is necessary.

Food(before/after)

Information Not Available

List of Contraindications

Cefotaxime and Pregnancy

Caution when used during pregnancy.
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters). 

Cefotaxime and Lactation

Caution when used during lactation

Cefotaxime and Geriatic

Information Not Available

Cefotaxime and Other Contraindications

Hypersensitivity to cephalosporins

Storage

Parenteral: Store below 30°C

Lab interference

Parenteral: Store below 30°C

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