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Cefotaxime is a semi-synthetic broad-spectrum bactericidal cephalosporin antibiotic. It is another β-lactam antibiotic whose mode of action is inhibition of bacterial cell wall synthesis. Cefotaxime is exceptionally active in vitro against Gram-negative organisms sensitive or resistant to first or second generation cephalosporins. It is similar to other cephalosporins in activity against Gram-positive bacteria.
Antibiotic Class: Third-Generation Cephalosporin
Antimicrobial Spectrum:
Staphylococcus aureus (methicillin susceptible), Coagulase negative Staphylococci, Streptococcus pneumoniae (penicillin susceptible), Streptococcus spp., Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitides, Neisseria gonorrhoeae, Enterobacteriaceae, E.coli
Mechanism of Action:
Cephalosporins exert bactericidal activity by interfering with bacterial cell wall synthesis and inhibiting cross-linking of the peptidoglycan. The cephalosporins are also thought to play a role in the activation of bacterical cell autolysins which may contribute to bacterial cell lysis.
Indications:
Treatment of susceptible organisms in lower respiratory tract, skin and skin structure, bone and joint, urinary tract, intra-abdominal, gynecologic as well as bacteremia/septicemia, and documented or suspected central nervous system infections (eg, meningitis). Active against most gram-negative bacilli (not Pseudomonas spp) and gram-positive cocci (not enterococcus). Active against many penicillin-resistant pneumococci.
Adverse Reactions:
Hypersensitivity: Maculopapular rash, Urticaria, Pruritis, Anaphylaxis/ angioedema, eosinophilia
Hematologic: Hypoprothrombinemia, Neutropenia, Leukopenia, Thrombocytopenia
GI: Diarrhea, C. difficile disease
Renal: Interstitial nephritis
Dosage:
IV: Powder for reconstitution: 500mg, 1g, 2g, 10g, 20g
Intravenous Solution: 1g/50mL, 2 g/50mL
Dosing in adults: Meningitis: 1-2 g IV/IM q8h Bone and/or joint infection: 1-2g IV/IM q8h
Gonococcal urethritis: 0.5g IM x 1 dose Lower respiratory tract infection: 1-2 g IV/IM q8h Bacterial peritonitis: 1-2g q8-12h
Dosing in pediatrics: 100-150mg/kd/day divided q4-6h
Contraindications/Warnings/Precautions:
Precautions:
hypersensitivity to penicillins, history of gastrointestinal disease, particularly colitis, renal impairment
Drug Interactions: Live Typhoid Vaccine: decreased immunological response to the typhoid vaccine
Pregnancy Risk Factor: B
Brand names/Manufacturer: CefotaximeÒ/American Pharmaceuticals; ClaforanÒ/Aventis