Cefotaxime

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Cefotaxime Brand Name– Claforan

What is Cefotaxime

Cefotaxime is a parenteral third-generation cephalosporin and was the first of this group to be marketed.

As with other agents in this group, cefotaxime is more active and has a broader spectrum against gram-negative species than earlier generations of cephalosporins.

Although it is less active against gram-positive bacteria than first-generation agents, cefotaxime is often an effective agent for the treatment of infections due to methicillin-sensitive S. aureus and susceptible strains of nonenterococcal streptococci.

The spectrum of activity of cefotaxime is similar to that of ceftizoxime and ceftriaxone; none of these cephalosporins is effective for the treatment of infections due to Pseudomonas aeruginosa.

Clinically, cefotaxime is used in the treatment of enteric gram-negative meningitis, serious bacteremias, pneumonia, and community-acquired infections.

Cefotaxime was approved by the FDA in 1981.

Indications

  1. Acinetobacter sp.
  2. bacteremia
  3. Bacteroides sp.
  4. bone and joint infections
  5. Borrelia burgdorferi
  6. cervicitis
  7. Citrobacter sp.
  8. Clostridium sp.
  9. community-acquired pneumonia
  10. Eikenella corrodens
  11. endocarditis
  12. endometritis
  13. Enterobacter sp.
  14. Escherichia coli
  15. Eubacterium sp.
  16. Fusobacterium nucleatum
  17. Fusobacterium sp.
  18. gastroenteritis
  19. gonorrhea
  20. gynecologic infections
  21. Haemophilus influenzae (beta-lactamase negative)
  22. Haemophilus influenzae (beta-lactamase positive)
  23. Haemophilus parainfluenzae
  24. infectious diarrhea
  25. intraabdominal infections
  26. Klebsiella pneumoniae
  27. Klebsiella sp.
  28. Leptospira sp.
  29. leptospirosis
  30. lower respiratory tract infections
  31. Lyme disease
  32. meningitis
  33. Moraxella catarrhalis
  34. Morganella morganii
  35. Neisseria gonorrhoeae
  36. Neisseria meningitidis
  37. pelvic cellulitis
  38. pelvic inflammatory disease (PID)
  39. Peptococcus sp.
  40. Peptostreptococcus sp.
  41. peritonitis
  42. pleural empyema
  43. pneumonia
  44. proctitis
  45. Propionibacterium sp.
  46. Proteus mirabilis
  47. Proteus vulgaris
  48. Providencia rettgeri
  49. Providencia sp.
  50. Providencia stuartii
  51. Pseudomonas sp.
  52. Salmonella sp.
  53. Salmonella typhi
  54. salmonellosis
  55. sepsis
  56. Serratia marcescens
  57. Shigella sp.
  58. sinusitis
  59. skin and skin structure infections
  60. Staphylococcus aureus (MSSA)
  61. Staphylococcus epidermidis
  62. Streptococcus agalactiae (group B streptococci)
  63. Streptococcus pneumoniae
  64. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  65. Streptococcus sp.
  66. surgical infection prophylaxis
  67. typhoid fever
  68. urethritis
  69. urinary tract infection (UTI)
  70. ventriculitis
  71. Viridans streptococci
  72. Yersinia enterocolitica

Side Effects

  1. abdominal pain
  2. acute generalized exanthematous pustulosis (AGEP)
  3. agranulocytosis
  4. anaphylactoid reactions
  5. angioedema
  6. aplastic anemia
  7. azotemia
  8. bleeding
  9. candidiasis
  10. cholecystitis
  11. cholelithiasis
  12. cholestasis
  13. colitis
  14. diarrhea
  15. dizziness
  16. elevated hepatic enzymes
  17. eosinophilia
  18. erythema multiforme
  19. fever
  20. headache
  21. hemolytic anemia
  22. injection site reaction
  23. interstitial nephritis
  24. Jarisch-Herxheimer reaction
  25. leukopenia
  26. maculopapular rash
  27. malaise
  28. nausea
  29. neutropenia
  30. pancytopenia
  31. pruritus
  32. pseudomembranous colitis
  33. renal failure (unspecified)
  34. seizures
  35. Stevens-Johnson syndrome
  36. thrombocytopenia
  37. toxic epidermal necrolysis
  38. urticaria
  39. vaginitis
  40. vomiting

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • agranulocytosis
  • breast-feeding
  • cephalosporin hypersensitivity
  • coagulopathy
  • colitis
  • corn hypersensitivity
  • diarrhea
  • geriatric
  • GI disease
  • hematological disease
  • inflammatory bowel disease
  • infusion-related reactions
  • leukopenia
  • neutropenia
  • penicillin hypersensitivity
  • pregnancy
  • pseudomembranous colitis
  • renal disease
  • renal impairment
  • sexually transmitted disease
  • thrombocytopenia
  • ulcerative colitis
  • vitamin K deficiency

Interactions

  • Amikacin
  • Aminoglycosides
  • Amlodipine; Celecoxib
  • Celecoxib
  • Colchicine; Probenecid
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Esomeprazole; Naproxen
  • Etodolac
  • Famotidine; Ibuprofen
  • Fenoprofen
  • Flurbiprofen
  • Gentamicin
  • Hydrocodone; Ibuprofen
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Kanamycin
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Loop diuretics
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nonsteroidal antiinflammatory drugs
  • Oral Contraceptives
  • Oxaprozin
  • Paromomycin
  • Piroxicam
  • Plazomicin
  • Probenecid
  • Rofecoxib
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Streptomycin
  • Sulindac
  • Tobramycin
  • Tolmetin
  • Valdecoxib
  • Warfarin

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