CEFOTETAN

Antibacterial activity

Cephalosporins, second generation
Effective against some gram-negative
Gram-positive coverage 
Good anaerobic coverage

Pregnancy Risk Factor

Class B

Contraindication/Precaution

Hypersensitivity to cefotetan, other cephalosporins or any component
Use caution if previous penicillins hypersensitivity:  10% of patient may have cross-hypersensitivity to cephalosporins
Use caution with nursing mothers
Use caution if vitamin K deficiency
Use caution if renal/liver dysfunction or if other nephrotoxic agents present
Use caution if history of ATB related colitis
Safety and effectiveness for use in children have not been established

Mechanism of Action

Inhibits cell wall synthesis (bactericidal)

Pharmacodynamics

Metabolism: N/A
Half-life: 3-4.6 hours, changes with renal function
Elimination: excreted mostly in urine and some in bile 

Dosage

Children: (Not FDA approved for children)

20-40 mg/kg IM/IV q12h (max 6 g/day)

Adults: (max 6 g/day)

Bacterial infections:
0.5-3 g IM/IV q12h
Prophylaxis: 
1-2 g IM/IV x 1 given  30-60 min before surgery or  after C-section

Dose VS renal function

Cr. clearance (ml/min):
<30: same dose, q48h 10-30: same dose, q24h >30: unchanged

Dialysis
Hemo: give 50% of usual dose post-dialysis then 25% normal dose q24h
CAPD: N/A