Cefotaxime - instructions for use, dose, side effects, contraindications

Semisynthetic antibiotic group of third generation cephalosporins for parenteral use. Has bactericidal action due to inhibition of bacterial cell wall synthesis. Violates the synthesis of the biopolymer peptidoglikana - the main component of the cell wall of bacteria. It inhibits the peptidoglycan transpeptidase, inhibits the activity of the endogenous inhibitor, which leads to activation of murein hydrolase, which cleaves peptidoglycan. Effective against fissile bacteria, in the walls of which the synthesis of peptidoglycan occurs.

It is active against gram-positive microorganisms: Staphylococcus spp., Streptococcus spp., Gram-negative microorganisms: Citrobacter spp., Enterobacter spp., Escherichia coli, Haemophilus influenzae, Moraxella spp., Klebsiella spp., including K. pneumoniae, Neisseria gonorrhoeae, N. meningitidis, P. vulgaris, Proteus mirabilis, Providencia spp., Salmonella spp., Serratia spp., Shigella spp., Yersinia spp., as well as anaerobic microorganisms: Fusobacterium spp., Veillonella spp.

Pharmacokinetics:

After intramuscular injection, the maximum concentration in the blood plasma is reached after 30 minutes, the bactericidal concentration is held for 12 hours.The connection with plasma proteins is 40%.

Penetrates into all organs and tissues. When meningitis gets into the cerebrospinal fluid. It is subject to partial metabolism in the liver. Do not cumulate. Penetrates through the placental barrier, is found in breast milk.

The elimination half-life is 1 hour. Elimination by the kidneys.

Indications:

It is used to treat infectious diseases caused by sensitive cefotaxime microorganisms: infections of the bronchopulmonary system (bronchitis, pneumonia, pleurisy, lung abscess), meningitis, infections of the skin, soft tissues, bones and joints, infections of the ear, throat, nose, urinary tract, kidney, gynecological infections, abdominal infections, acute uncomplicated gonorrhea .

In surgical practice, they are used to reduce the risk of post-operative infections, especially in operations on the organs of the gastrointestinal tract and urological operations.

ICD-10

I.A30-A49.A40 Streptococcal septicemia

I.A30-A49.A41 Other septicemia

I.A50-A64.A54 Gonococcal infection

I.A65-A69.A69.2 Lyme disease

X.J10-J18.J15 Bacterial pneumonia, not elsewhere classified

X.J20-J22.J20 Acute bronchitis

X.J40-J47.J42 Chronic bronchitis, unspecified

XI.K65-K67.K65.0 Acute peritonitis

XI.K80-K87.K81.1 Chronic cholecystitis

XI.K80-K87.K81.0 Acute cholecystitis

XI.K80-K87.K83.0 Cholangitis

XII.L00-L08.L01 Impetigo

XII.L00-L08.L02 Abscess of skin, boil and carbuncle

XII.L00-L08.L03 Phlegmon

XII.L00-L08.L08.0 Pyoderma

XIII.M00-M03.M00 Pyogenic arthritis

XIII.M86-M90.M86 Osteomyelitis

XIV.N10-N16.N11 Chronic tubulointerstitial nephritis

XIV.N10-N16.N10 Acute tubulointerstitial nephritis

XIV.N30-N39.N30 Cystitis

XIV.N30-N39.N34 Urethritis and urethral syndrome

XIV.N40-N51.N41 Inflammatory diseases of the prostate

XIV.N70-N77.N70 Salpingitis and oophoritis

XIV.N70-N77.N71.0 Acute inflammatory disease of the uterus

XIV.N70-N77.N72 Inflammatory disease of the cervix

XIX.T79.T79.3 Post-traumatic wound infection, not elsewhere classified

XXI.Z20-Z29.Z29.2 Another type of preventive chemotherapy

Contraindications:

Individual intolerance to β-lactam antibiotics: penicillins and cephalosporins.

Carefully:

Imbalance of electrolytes or fluids, severe liver damage, colitis in history.

Pregnancy and lactation:

Recommendations for FDA - Category B. It is used with caution during pregnancy and lactation in cases where the intended benefit exceeds the risk to the fetus and newborn.

Dosing and Administration:

Use in children

Intramuscularly and intravenously, depending on age:

- premature: 50 mg / kg per day, if the kidney function is disturbed - 25 mg / kg per day;

- newborns up to 7 days: 50 mg / kg per day every 12 hours;

- newborns from 1 to 4 weeks: 50 mg / kg per day every 8 hours;

- from 1 month to 12 years: 50-180 mg / kg per day.

Adults

Intramuscularly deep or intravenously slowly 1-2 g, with uncomplicated infections every 12 hours, of medium gravity - every 8 hours, with severe infections of 2 g every 8, 6, 4 hours.

The highest daily dose: 12 g.

The highest single dose: 2 g.

Side effects:

Central and peripheral nervous system: rarely - convulsions.

Hemopoietic system: thrombocytopenia, eosinophilia, leukopenia, an increase in prothrombin index and coagulation time.

Digestive system: nausea, vomiting, diarrhea, increased activity of hepatic enzymes, hepatic or cholestatic jaundice, intestinal dysbacteriosis.

Dermatological reactions: local reactions - compaction at the injection site, candidiasis dermatitis, vulvovaginitis.

urinary system: rarely - the development of hypokalemia.

Allergic reactions.

Overdose:

Nausea, vomiting, diarrhea, neuromuscular excitability, convulsive attacks.

Treatment is symptomatic, hemodialysis.

Interaction:

Simultaneous application with probenecid slows the renal excretion of cefotaxime.

"Loop diuretics" block the tubular secretion of cefotaxime.

Special instructions:

Cefotaxime is not recommended for the treatment of meningitis.

Simultaneous use with ethanol can cause a disulfiram-like reaction.

Instructions

Cefotaxime (Cefotaximum)