Cefotaxime is a third-generation, broad-spectrum, bactericidal cephalosporin antibiotic. It is highly effective against Gram-negative bacteria, including many beta-lactamase-producing strains, while retaining significant activity against Gram-positive organisms. It is a cornerstone of empirical therapy for serious hospital-acquired infections in India, particularly in ICU settings, due to its stability against many plasmid-mediated beta-lactamases.
Adult: Moderate infections: 1gm IV/IM every 12 hours. Severe infections: 1-2gm IV every 6-8 hours. Life-threatening infections (e.g., meningitis, septic shock): Up to 2gm IV every 4 hours.
Note: IV: Reconstitute 1gm vial with 10 mL Water for Injection. For IV bolus, administer over 3-5 minutes. For IV infusion, further dilute in 50-100 mL of compatible fluid (NS, D5W, RL) and infuse over 20-30 minutes. IM: Reconstitute with 2-3 mL of Water for Injection or 1% Lidocaine HCl (without epinephrine) to reduce pain. Inject deep into a large muscle mass. Solutions are light yellow; discard if discolored or contains particulate matter.
Cefotaxime is a bactericidal beta-lactam antibiotic. It inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) located inside the bacterial cell wall. This binding inhibits the final transpeptidation step of peptidoglycan synthesis, leading to the formation of a defective cell wall and ultimately to osmotic lysis and cell death.
Pregnancy: Pregnancy Category B. Animal studies have shown no direct fetal harm. Cefotaxime crosses the placenta. Should be used during pregnancy only if clearly needed. Considered a drug of choice for treating serious infections in pregnant women when a cephalosporin is indicated.
Driving: Generally safe. However, patients experiencing side effects like dizziness or headache should avoid driving or operating machinery.
| Probenecid | Inhibits renal tubular secretion of cefotaxime, increasing and prolonging serum levels. | Moderate |
| Aminoglycosides (e.g., Gentamicin, Amikacin) | Synergistic antibacterial effect against some organisms (e.g., Pseudomonas). Increased risk of nephrotoxicity. | Moderate |
| Potent Diuretics (e.g., Furosemide) | May increase the risk of nephrotoxicity. | Moderate |
| Oral Anticoagulants (Warfarin) | May potentiate anticoagulant effect, increasing risk of bleeding. | Major |
| Chloramphenicol | Antagonistic antibacterial effect; avoid concomitant use. | Major |