Trade Names:Claforan- Powder for injection 500 mg- Powder for injection 1 g- Powder for injection 2 g- Powder for injection 10 g- Injection 1 g- Injection 2 g
Inhibits mucopeptide synthesis in bacterial cell wall.
C max is 11.7 mcg/mL (500 mg dose) and 20.5 mcg/mL (1 g dose). T max is about 0.5 h.
Cefotaxime is metabolized to desacetyl derivative (active).
About 60% is recovered in the urine in 6 h; about 20% to 36% is excreted as unchanged cefotaxime and 15% to 25% as desacetyl derivative. The t ½ is 60 min (adults); 3 to 5 h (infants).
Treatment of infections of lower respiratory tract including pneumonia, urinary tract, skin and skin structures, bone and joints; treatment of bacteremia/septicemia, CNS infections, intra-abdominal infections including peritonitis, gynecological infections including pelvic inflammatory disease, endometritis and pelvic cellulitis caused by susceptible strains of specific microorganisms; perioperative prophylaxis.
Hypersensitivity to cephalosporins.
IV/IM Up to 12 g/day in divided doses (from every 4 h for septicemia to every 12 h for uncomplicated infection) usually for 7 to 10 days. IV route is preferable for severe infections.Children 1 mo to 12 yr of age (weighing less than 50 kg)
IV/IM 50 to 180 mg/kg/day in 4 to 6 divided doses.Children 1 mo to 12 yr of age (weighing more than 50 kg)
Usual adult dose (max, 12 g/day).Infants 1 to 4 wk of age
IV 50 mg/kg every 8 h.Newborns younger than 1 wk of age
IV 50 mg/kg every 12 h.Gonococcal Urethritis/Cervicitis in Men and WomenAdults
IM 0.5 g as single dose.Rectal GonorrheaAdults
IM 0.5 g as single dose (women); 1 g as single dose (men).Perioperative ProphylaxisAdults
IV/IM 1 g 30 to 90 min prior to surgery.Cesarean SectionAdults
IV 1 g as soon as umbilical cord is clamped; second and third dose IV/IM at 6- and 12-h intervals after first dose.Dosage Adjustment for Renal Function Impairment
Reduce dose 50% in patients with Ccr less than 20 mL/min.
Store vials and bottles of dry powder below 86°F. Protect from light and excessive temperature. Refer to manufacturer's guidelines for storage and stability recommendations for reconstituted solutions. Store premixed frozen injection in freezer capable of maintaining temperature of −4°F. Thawed solution is stable for 10 days under refrigeration (at or below 41°F) or 24 h at or below 72°F. Do not refreeze thawed antibiotics.
Increased risk of nephrotoxicity.
Do not add aminoglycosides to cefotaxime solutions because inactivation of both drugs may result; administer at separate sites if concurrent therapy is indicated.
False-positive direct Coombs test results in certain patients (eg, those with azotemia).
Colitis, diarrhea, nausea, vomiting (at least 1%); pseudomembranous colitis symptoms can occur during or after treatment.
Rash, pruritus, fever, eosinophilia, urticaria, anaphylaxis (at least 1%).
Injection-site inflammation with IV administration; pain and induration, tenderness after IM administration (at least 1%).
Review results of culture and sensitivity testing as appropriate. Ensure that cefotaxime is discontinued and another antimicrobial agent is started if sensitivity tests indicate that the organism is resistant to cefotaxime.
Category B .
Excreted in breast milk.
Because elderly patients are more likely to have decreased renal function, use care in dose selection and consider monitoring renal function.
Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity.
Use with caution. Reduce dose when Ccr is less than 20 mL/min.
May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Use with caution, especially in patients with history of colitis.
Granulocytopenia, and more rarely, agranulocytosis, may develop during treatment with cefotaxime, particularly if given over long periods. Monitor CBC during course of treatment lasting longer than 10 days.
May be locally irritating to tissues in the event of extravasation. Regularly monitor infusion sites and change when appropriate.
Consider in patients in whom diarrhea develops.
Elevated BUN and creatinine.
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