Cefotaxime

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

Mild infection: 1 g every 12 hours

Moderate infection: 1 g every 8 hours

Severe infection: 2 g every 6 hours

Life-threatening infection: up to 12 g daily in 3–4 divided doses

PHARMACOKINETICS

Molecular weight :477.4 (as sodium salt)

%Protein binding :40

%Excreted unchanged in urine : 40–60

Volume of distribution (L/kg) :0.15–0.55

half-life – normal/ESRD (hrs) :0.9–1.14/2.5 (10 hours for the metabolite)

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : 1 g every 8–12 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Dialysed. Dose as in GFR

<10 : mL/min

HDF/high flux :Dialysed. Dose as in GFR

<10 : mL/min

CAV/VVHD :Dialysed. 1–2 g every 12 hours

CVVhd/HDFDialysed. 2 g every 12 hours1

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: effects of coumarins may be enhanced

ADMINISTRATION

Reconstition

IV Bolus/IM: 4 mL water for injection to 1 gIV Infusion: 1 g in 50 mL sodium chloride 0.9%

Route

IV, IM

Rate of Administration

Bolus over 3–4 minutes; infusion over 20–60 minutes

Comments

–

OTHER INFORMATION

1 g contains 2.09 mmol sodium

Reduce dose further if concurrent hepatic and renal failure

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