CEFOTAXIME

Antibacterial activity

Cephalosporin, third generation
Effective against gram-negative 
Gram-positive coverage 
Anaerobic coverage (no B. fragilis or C. difficile coverage)

Pregnancy Risk Factor

Class B

Contraindication/Precaution

Hypersensitivity to cefotaxime, other cephalosporins or any component
Use caution if previous penicillins hypersensitivity:  10% of patient may have cross-hypersensitivity to cephalosporins
Use caution if seizure disorder
Use caution if renal/liver dysfunction or if other nephrotoxic agents used
Use caution if history of ATB related colitis

Mechanism of Action

Inhibits cell wall synthesis (bactericidal)

Pharmacodynamics

Metabolism: liver, in part
Half-life: 1 hours, changes with hepatic function
Elimination: excreted in urine

Dosage

Children: (max 12 g/day)

Body weight < 2000 g 0-7 days old:  50 mg/kg IM/IV q12h 8-28 days old: 50 mg/kg IM/IV q8h Body weight > 2000 g
0-7 days old: 50 mg/kg IM/IV q12h
8-28 days old:  50 mg/kg IM/IV q8h
> 28 days old:  50 mg/kg IM/IV q8h (75 mg/kg q6h for meningitis)

Adults: (max 12 g/day)

1-2 g IM/IV q6-12h

Dose VS renal function

Cr. clearance (ml/min):
<10: 1-2 g IM/IV q24h 10-50: 1-2 g IM/IV q12h 50-80: unchanged >80: unchanged
Dialysis
Hemo:  1 g IM/IV post dialysis
CAPD: 0.5-1 g IM/IV qd