Formulary
Cefotaxime: Indications, Dosing, Side Effects and Interactions
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
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Cefotaxime: Indications, Dosing, Side Effects and Interactions
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
Drug action
Cephalosporins are antibacterials that attach to penicillin binding proteins to interrupt cell wall biosynthesis, leading to bacterial cell lysis and death.
Indications and dose
**Uncomplicated gonorrhoea**
- **Adult** (By Intramuscular Injection): 500-1000 mg for 1 dose.
**Infections due to sensitive Gram-positive and Gram-negative bacteria,Surgical prophylaxis,Haemophilus epiglottitis**
- **Adult** (By Intramuscular Injection, Or By Intravenous Injection, Or By Intravenous Infusion): 1 g every 12 hours.
**Severe susceptible infections due to sensitive Gram-positive and Gram-negative bacteria,Meningitis**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): 8 g daily in 4 divided doses, increased if necessary to 12 g daily in 3-4 divided doses.
**Uncomplicated gonorrhoea for cefotaxime**
- **Child 12-17 years** (By intramuscular injection): 500-1000 mg for 1 dose.
**Severe exacerbations of Haemophilus influenzae infection in cystic fibrosis for cefotaxime**
- **Child** (By intravenous injection, or by intravenous infusion): 50 mg/kg every 8 hours (max. per dose 4 g), alternatively 50 mg/kg every 6 hours (max. per dose 3 g).
**Infections due to sensitive Gram-positive and Gram-negative bacteria, Surgical prophylaxis, Haemophilus epiglottitis for cefotaxime**
- **Neonate up to 7 days** (By intramuscular injection, or by intravenous injection, or by intravenous infusion): 25 mg/kg every 12 hours.
- **Neonate 7 days to 20 days** (By intramuscular injection, or by intravenous injection, or by intravenous infusion): 25 mg/kg every 8 hours.
- **Neonate 21 days to 28 days** (By intramuscular injection, or by intravenous injection, or by intravenous infusion): 25 mg/kg every 6-8 hours.
- **Child** (By intramuscular injection, or by intravenous injection, or by intravenous infusion): 50 mg/kg every 8-12 hours.
**Severe susceptible infections due to sensitive Gram-positive and Gram-negative bacteria, Meningitis for cefotaxime**
- **Neonate up to 7 days** (By intravenous injection, or by intravenous infusion): 50 mg/kg every 12 hours.
- **Neonate 7 days to 20 days** (By intravenous injection, or by intravenous infusion): 50 mg/kg every 8 hours.
- **Neonate 21 days to 28 days** (By intravenous injection, or by intravenous infusion): 50 mg/kg every 6-8 hours.
- **Child** (By intravenous injection, or by intravenous infusion): 50 mg/kg every 6 hours (max. per dose 3 g).
Side effects
Common or very common Abdominal pain; diarrhoea; dizziness; eosinophilia; headache; leucopenia; nausea; neutropenia; pseudomembranous enterocolitis; skin reactions; thrombocytopenia; vomiting Uncommon Anaphylactic reaction; angioedema Rare or very rare Agranulocytosis; haemolytic anaemia; nephritis tubulointerstitial (reversible); severe cutaneous adverse reactions (SCARs) Side-effects For cefotaxime Uncommon Drug fever; Jarisch-Herxheimer reaction; renal impairment; seizure Frequency not known Arrhythmia (following rapid injection); bronchospasm; encephalopathy; fungal infection; hepatic disorders
Pregnancy
Not known to be harmful.
Breast feeding
Present in milk in low concentration, but appropriate to use.
Renal impairment
Dose adjustments See Prescribing in renal impairment . If eGFR less than 5 mL/minute/1.73 m 2 , initial dose of 1 g then use half normal dose. M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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