Classifications: antibiotic; third-generation cephalosporin; Therapeutic: antibiotic; cephalosporin
Prototype: Cefotaxime sodium
Pregnancy Category: B
100 mg, 200 mg tablets; 10 mg/mL, 20 mg/mL suspension
Semisynthetic beta-lactam cephalosporin antibiotic. It inhibits the third and final stage of bacterial cell wall synthesis
by preferentially binding to specific penicillin-binding proteins (PBPs) within the bacterial cell wall.
Has antibacterial activity resembling that of other third-generation cephalosporins. Stable in the presence of beta-lactamases.
Highly active against gram-negative bacteria.
Gonorrhea, otitis media, lower and upper respiratory tract infections, urinary tract infections.
Skin and soft tissue infections.
Hypersensitivity to cephalosporins and other beta-lactam antibiotics.
Renal impairment, history of type I hypersensitivity reactions to penicillins; coagulopathy; history of colitis or other
GI disease; lactation, pregnancy (category B).
Route & Dosage
|Respiratory Tract, Skin, and Soft Tissue Infections
Adult: PO 200 mg q12h for 10 d
Child: PO 10 mg/kg/d divided q12h
Urinary Tract Infections
Adult: PO 100 mg q12h
Adult: PO 200 mg as single dose
Child (5 mo12 y): PO 10 mg/kg/d divided q1224h
- Give with food to enhance absorption.
- Give 1 h before or 2 h after an antacid.
- Consult physician regarding patients with renal impairment (i.e., creatinine clearance less than 30 mL/min); dosage intervals
should be every 12 h.
- Patients on hemodialysis should be given usual dose 3 times weekly after hemodialysis.
- Preparation of suspension: To either the 50 mg/5 mL strength or the 100 mg/5 mL strength, add 25 mL of distilled water,
then shake vigorously for 15 seconds. Next, to the 50 mg/5 mL strength add 33 mL, or to the 100 mg/5 mL strength add 32
mL, of distilled water, and shake for at least 3 minutes.
- Store suspension for up to 14 d in a refrigerator [2°8° C (36°46° F)]. Shake well before using.
Adverse Effects (≥1%) Body as a Whole:
Eye itching, cough, epistaxis, fever, decreased appetite, malaise
. GI: Diarrhea
, nausea, vomiting, abdominal pain, soft stools, flatulance, pseudomembranous colitis
rare: Headache, asthenia, dizziness, fatigue
, anxiety, insomnia
, flushing, nightmares, weakness. Urogenital:
Urticaria, rash, scaling, peeling.
may decrease absorption. Food:
Food may increase the absorption.
4050% absorbed from GI tract. Onset:
Therapeutic effect in 3 d. Distribution:
Distributes well into inflammatory, pulmonary
, and pleural fluid, and tonsils. Some distribution into prostate. 40%
bound to plasma proteins
. Distributed into breast milk. Elimination:
80% in urine. Half-Life:
Assessment & Drug Effects
- Determine history of hypersensitivity reactions to cephalosporins and penicillins, and history of allergies, particularly
to drugs, before therapy is initiated.
- Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy, if indicated.
Therapy may be instituted pending test results.
- Report onset of loose stools or diarrhea. Although pseudomembranous enterocolitis (see Appendix F) rarely occurs, this potentially
life-threatening complication should be ruled out as the cause of diarrhea during and after antibiotic therapy.
- Monitor for manifestations of hypersensitivity (see Appendix F). Discontinue drug and report S&S of hypersensitivity promptly.
- Monitor I&O rates and pattern: Especially important with high doses; report any significant changes.
Patient & Family Education
- Report any signs or symptoms of hypersensitivity immediately.
- Report loose stools, or diarrhea, especially if containing blood, mucus, or pus.
- Complete the full course of drug therapy even if symptoms improve.