Cefotaxime : Therapeutic uses, Dosage & Side Effects
Cefotaxime is the prototype of the third generation cephalosporins. It is deacetylated in the body; the metabolite exerts weaker but synergistic action with the parent drug.
Dose : 1-2 g i.m./i.v. 8-12 hourly, children 50–100 mg/kg/day
Route : IM, IV
Onset of action : ?
Plasma Half-life : 1 hours (longer for the deacetylated metabolite-permitting 12 hourly doses in many situations)
Duration of action : ?
Bioavailability : ?
Plasma protein binding : ?
Metabolism : Liver
Pregnancy risk category : B
Chemical formula : C16H17N5O7S2
IUPAC name : (6R,7R,Z)-3-(Acetoxymethyl)-7-(2-(2-aminothiazol-4-yl)-2-(methoxyimino)acetamido)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid
Trade name : Omnatax, Oritaxim, Claforan
Antibacterial spectrum : Cefotaxime exerts potent action on aerobic gram-negative as well as some gram-positive bacteria, but is not active on anaerobes (particularly Bact. fragilis), Staph. aureus and Pseudomonas aeruginosa.
Therapeutic uses : Cefotaxime is prominently indicated for meningitis caused by gram-negative bacilli (attains relatively high CSF levels), life-threatening resistant/ hospital-acquired infections, septicaemias and infections in immunocompromised patients. It is also utilized for single dose therapy (1 g i.m. + 1 g probenecid oral) of PPNG urethritis, but is not dependable for Pseudomonas infections.
Mechanism of action : Cephalosporins cause inhibition of bacterial cell wall synthesis. i.e. they have the same mechanism of action as penicillin. However, they bind to different proteins than those which bind penicillins.
Side effects : Cephalosporins are generally well tolerated, but are more toxic than penicillin. Cefotaxime may provoke following side effects :
- Colitis, diarrhea, nausea, vomiting,
- Hypersensitivity : Rash, pruritus, fever,
- Pain and inflammation at the site of injection/infusion,
- Symptoms of pseudomembranous colitis can appear during or after antibiotic treatment.
Drug Interactions : Cefotaxime may interact with following drugs :
- Probenecid : Decreasing the total clearance of drug by approximately 50% and increasing the plasma concentrations.
- Aminoglycosides, NSAIDs & furosemide : May potentiate the nephrotoxic effects of nephrotoxic drugs
Contraindications :
- Contraindicated in patients who have shown hypersensitivity to Cefotaxime sodium, or the cephalosporins.
For detailed query or in case of uncertainty, Always consult your doctor or pharmacist.
