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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :477.4 (as sodium salt)
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :40
  • %Excreted unchanged in urine &nbsp &nbsp : 40–60
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.15–0.55
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :0.9–1.14/2.5 (10 hours for the metabolite)

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : 1 g every 8–12 hours

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min
  • HDF/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: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