Cefotaxime

Indications
 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
Skin and skin structure 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
Central nervous system 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
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
Bone and joint 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
Genitourinary 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
Gynaecological 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
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
Lower respiratory 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
Prophylaxis of surgical infections
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.

Special Populations: In renal impairment with CrCl of ≤5 mg/min, cefotaxime dose is reduced by 50%. Treatment is continued for up to 72 hr after relief of symptoms and for at least 10 days in Group A beta-haemolytic streptococcal infections.
Contraindications
 Hypersensitivity to cephalosporins.
Warnings / Precautions
 History of penicillin allergy; colitis; impaired renal function; pregnancy, lactation.
Adverse Reactions
 Pain at inj site; hypersensitivity reactions, rash, pruritus; diarrhoea, nausea, vomiting; candidiasis; eosinophilia, neutropenia, leucopenia, thrombocytopenia.
Potentially Fatal: Anaphylactic reaction; nephrotoxicity.
Drug Interactions
 Probenecid decreases cefotaxime elimination.
Potentially Fatal: Nephrotoxicity with furosemide and aminoglycosides.
See Below for More cefotaxime Drug Interactions
Lab Interactions
 False-positive result for urine-glucose, serum or urine creatinine with Jaffe reaction.
Mechanism of Actions
 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.
Storage Conditions
 Parenteral: Store below 30°C.
ATC Classification
 J01DD01 - cefotaxime ; Belongs to the class of third-generation cephalosporins. Used in the systemic treatment of infections.
Storage
 Parenteral: Store below 30°C.
Available As
  • Cefotaxime 1 gm
  • Cefotaxime Sodium 1 gm
  • Cefotaxime 1000 mg
  • Cefotaxime Sodium 1000 mg
  • Cefotaxime 125 mg
  • Cefotaxime Sodium 125 mg
  • Cefotaxime 1500 mg
  • Cefotaxime 200 mg
  • Cefotaxime 2000 mg
  • Cefotaxime 250 mg
  • Cefotaxime Sodium 250 mg
  • Cefotaxime 50 mg
  • Cefotaxime 500 mg
  • Cefotaxime Sodium 500 mg

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