Drugs

Cefotetan : Therapeutic uses, Dosage & Side Effects

Cefotetan : Therapeutic uses, Dosage & Side Effects

Cefotetan is an second generation cephalosporin antibiotic. It is used for treating bacterial infections or preventing bacterial infections before, during, or after certain surgeries.
Dose : 1-10 g, 1-2 g/100 mL, 1-2 g/50 mL-iso-osmotic dextrose, 1-2 g/50 mL
Route : IM, IV
Onset of action : ?
Plasma Half-life : 3-4.6 hours
Duration of action : ?
Bioavailability : ?
Plasma protein binding : 88%
Metabolism : ?
Pregnancy risk category : B
Chemical formula : C17H17N7O8S4
IUPAC name : (7S)-7-{[4-(1-amino-3-hydroxy-1,3-dioxopropan-2-ylidene)1,3-dithietane-2-carbonyl]amino}-7-methoxy-3-[(1-methyltetrazol-5-yl)sulfanylmethyl]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid
Trade name : Cefotan, Apatef
Antibacterial spectrum : Cefotetan has a broad spectrum of activity. Notable species include Bacteroides, Streptococcus, and Escherichia. Cefotetan has been shown to be active against most strains of the following organisms :

  • Gram-Negative Aerobes : E. coli, H. influenzae (including ampicillin-resistant strains), Klebsiella species (including K. pneumoniae), Morganella morganii, Serratia marcescens, Neisseria gonorrhoeae (nonpenicillinase-producing strains), Proteus mirabilis, Proteus vulgaris, Providencia rettgeri. Approximately one-half of the usually clinically significant strains of Enterobacter species (e.g., E. aerogenes and E. cloacae) are resistant to Cefotetan. Most strains of Pseudomonas aeruginosa and Acinetobacter species are resistant to Cefotetan.
  • Gram-Positive Aerobes : Staph. aureus (including penicillinase- and nonpenicillinase-producing strains), Staph. epidermidis, Strept. agalactiae (group B beta-hemolytic Strept.), Strept. pneumoniae, Strept. pyogenes. Methicillin-resistant staphylococci are resistant to cephalosporins. Some strains of Staph. epidermidis and most strains of enterococci, e.g., Enterococcus faecalis (formerly Strept. faecalis) are resistant to Cefotetan.
  • Anaerobes : Prevotella bivia (formerly Bacteroides bivius), Prevotella disiens (formerly Bacteroides disiens), Bacteroides fragilis, Prevotella melaninogenica (formerly Bacteroides melaninogenicus), Bacteroides vulgatus, Fusobacterium species, Gram-positive bacilli (including Clostridium species), Peptococcus niger, PeptoStrept. species. Most strains of C. difficile are resistant.

Therapeutic uses : Cefotetan is indicated for the treatment of the following infections when caused by susceptible strains of the organisms :

  • Urinary Tract Infections
  • Lower Respiratory Tract Infections
  • Gynecologic Infections
  • Skin and Skin Structure Infections
  • Intra-abdominal lnfections
  • Bone and Joint Infections

The preoperative administration of Cefotetan may reduce the incidence of certain postoperative infections in patients undergoing surgical procedures.
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. Cefotetan may exhibit following side effects :

  • GIT effects : diarrhea, nausea
  • Hematologic effects : eosinophilia, positive direct Coombs test, thrombocytosis, agranulocytosis, hemolytic anemia, leukopenia, thrombocytopenia, and prolonged prothrombin time.
  • Hepatic effects : enzyme elevations including rise in ALT (SGPT), AST (SGOT), alkaline phosphatase, and LDH.
  • Hypersensitivity reactions: rash, itching, anaphylactic reactions and urticaria.
  • Phlebitis at the site of injection
  • Renal effects : Elevations in BUN and serum creatinine.

Drug Interactions : Cefotetan may interact with following drugs :

  • Aminoglycosides : Renal function should be carefully monitored, because nephrotoxicity may be potentiated.

Contraindications :

  • Contraindicated in patients with a known allergy to the cephalosporins and in those individuals who have experienced a cephalosporin associated hemolytic anemia.

For detailed query or in case of uncertainty, Always consult your doctor or pharmacist.

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