Cefotiam
General
- Type: 2nd generation 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[1]
| 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 | 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▍ |