Ver el código de «Cefotiam»

==General==
*Type: [[Is Generation::2nd generation]] [[Is DrugClass::Cephalosporin]]
*Dosage Forms: Powder for injection, tablet (as cefotiam hexetil)
*Dosage Strengths: 250mg, 500mg, 1g, 2g
*Routes of Administration: IV, IM, PO
*Common Trade Names: Pansporin, Halospor

==Adult Dosing==
===General (Parenteral)===
*Susceptible infections: 0.5-2g IV/IM divided q6-12h depending on severity
*Max: 6g/day
*Sepsis/Severe infections: Up to 4g/day divided q6-8h

===General (Oral)===
*200-400mg PO bid

===Surgical Prophylaxis===
*1g IV single dose (30-60 min before procedure)
*May repeat post-operatively if procedure is prolonged

==Pediatric Dosing==
===General===
*40-80 mg/kg/day IV/IM divided q6-8h
*Severe infections: Up to 160 mg/kg/day divided q6-8h
*Max: Adult dosing limits

==Special Populations==
*Pregnancy: Category B
*Lactation: Excreted in breast milk; use with caution
*Renal
**Dose reduction required for renal impairment
**Adult
***CrCl >30: Standard dosing
***CrCl 10-30: Reduce does by 50% or extend interval (q12-24h)
***CrCl <10: Reduce dose by 50-75% and give q24h
***Hemodialysis: Supplement required after dialysis
*Hepatic
**No specific adjustment defined

==Contraindications==
*Allergy to class/drug (Cephalosporins)
*History of anaphylactic reaction to Penicillins

==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*[[Toxic Epidermal Necrolysis]]
*Pseudomembranous colitis ([[Clostridium difficile]])
*Nephrotoxicity
*Bleeding disorders (hypoprothrombinemia)
*Seizures (high doses in renal failure)

===Common===
*[[Diarrhea]]
*[[Nausea and Vomiting]]
*[[Rash]]
*Injection site pain/phlebitis
*Elevated LFTs
*Eosinophilia

==Pharmacology==
*Half-life: 0.6 - 1.0 hours (prolonged in renal failure)
*Metabolism: Not significantly metabolized (excreted unchanged)
*Excretion: Urine (primary)
*Mechanism of Action: Bactericidal; inhibits cell wall synthesis (final cross-linking of peptidoglycan)
*Drug Interactions: 
**Disulfiram-like reaction with alcohol
**Probenecid reduces renal clearance

==[[Antibiotic Sensitivities]]<ref>[https://mims.com/malaysia/drug/info/cefotiam?mtype=generic MIMS Cefotiam]</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||'''S'''
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||I
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||R
|-
| ||Serratia marcescens||R
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||I
|-
| ||[[Providencia sp.]]||I
|-
| ||[[Morganella sp.]]||I
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||I
|-
| ||[[Citrobacter sp.]]||I
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||X1
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vuln▍