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
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.
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.
Hypersensitivity: Maculopapular rash, Urticaria, Pruritis, Anaphylaxis/ angioedema, eosinophilia
Hematologic: Hypoprothrombinemia, Neutropenia, Leukopenia, Thrombocytopenia
GI: Diarrhea, C. difficile disease
Renal: Interstitial nephritis
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
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