Cefotaxime

General

• Type: 3rd generation cephalosporin
• Dosage Forms: injectable solution, powder for injection
• Dosage Strengths: injectable solution: 20, 40mg/mL; powder for injection: 500mg, 1g, 2g, 10g
• Routes of Administration: IV, IM
• Common Trade Names: Claforan

Adult Dosing

Indications by Disease

Disease	Dose	Context
Acute cystitis	1-2gm IV q8hr	Inpatient
Brain abscess	2gm IV q6hr	Otogenic
Orbital cellulitis	2 g IV q4h	Inpatient
Pneumonia (main)	1–2g q8h	Inpatient, CAP Non-ICU
Pyelonephritis	1-2gm IV q8hr	Adult Inpatient

Pediatric Dosing

Indications by Disease

Disease	Dose	Context
Acute cystitis	50mg/kg IV q8hrs (max 2g/dose)	Pediatric Inpatient
Brain abscess	50mg/kg IV q6hrs (max 2g/dose)	Pediatric Empiric
Neonatal conjunctivitis	100mg/kg IV or IM x1	Gonococcal conjunctivitis
Orbital cellulitis	50mg/kg IV q6hrs (max 2g/dose)	Pediatric Inpatient
Osteomyelitis	50mg/kg IV three times daily	Sickle Cell Disease
Peritonitis	50mg/kg IV q8hrs (max 2g/dose)	Pediatric
Pneumonia (peds)	200mg/kg/day div q8hrs	1-3 month febrile pneumonia
Pyelonephritis	50mg/kg IV q8hrs	Pediatric Inpatient
Ventriculoperitoneal shunt infection	200mg/kg/day IV div q6hrs	Empiric with Vancomycin

Special Populations

• Pregnancy:
• Lactation:
• Renal Dosing
  • Adult
  • Pediatric
• Hepatic Dosing
  • Adult
  • Pediatric

Contraindications

• Allergy to class/drug

Pharmacology

• Half-life: 1-2 hr
• Metabolism: Partially metabolized in liver
• Excretion: Urine
• Mechanism of Action: Inhibits bacterial cell wall synthesis

Antibiotic Sensitivities

Group	Organism	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	X1
	MSSA	S
	MRSA	R
	CA-MRSA	R
	Staph. Epidermidis	I
	C. jeikeium	R
	L. monocytogenes	R
Gram Negatives	N. gonorrhoeae	I
	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	S
	Enterobacter sp, AmpC pos	R
	Serratia sp	S
	Serratia marcescens	X1
	Salmonella sp	S
	Shigella sp	S
	Proteus mirabilis	S
	Proteus vulgaris	S
	Providencia sp.	S
	Morganella sp.	S
	Citrobacter freundii	S
	Citrobacter diversus	S
	Citrobacter sp.	S
	Aeromonas sp	S
	Acinetobacter sp.	R
	Pseudomonas aeruginosa	R
	Burkholderia cepacia	I
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	S
	Francisella tularensis	X1
	Brucella sp.	X1
	Legionella sp.	R
	Pasteurella multocida	S
	Haemophilus ducreyi	S
	Vibrio vulnificus	X1
Misc	Chlamydophila sp	X1
	Mycoplasm pneumoniae	X1
	Rickettsia sp	X1
	Mycobacterium avium	X1
Anaerobes	Actinomyces	X1
	Bacteroides fragilis	R
	Prevotella melaninogenica	S
	Clostridium difficile	R
	Clostridium (not difficile)	S
	Fusobacterium necrophorum	X1
	Peptostreptococcus sp.	S

Key

• S susceptible/sensitive (usually)
• I intermediate (variably susceptible/resistant)
• R resistant (or not effective clinically)
• S+ synergistic with cell wall antibiotics
• U sensitive for UTI only (non systemic infection)
• X1 no data
• X2 active in vitro, but not used clinically
• X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
• X4 active in vitro, but not clinically effective for strep pneumonia

See Also

• Antibiotics (Main)