Clinical medicine profile
Cefotaxime
Beta-lactam antibiotic — cephalosporin
- Route
- INTRAMUSCULAR, INTRAVENOUS
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Serious hypersensitivity to cephalosporins.
- Use extreme caution or avoid if prior anaphylaxis to penicillins (cross-reactivity lower than historically feared but not zero, especially similar side chains).
Precautions
- Allergy history.
- Superinfection / C. difficile risk.
- Adjust renally cleared agents for CrCl.
- Ceftriaxone: avoid concurrent IV calcium in neonates
- biliary sludge with prolonged use.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
By I.M or I.V injection or infusion, 1g every 12hours increased in severe infections [e.g. meningitis] to 8g daily in 4 divided doses; higher doses [up to 12g daily in 34 divided doses] may be required; neonate 50mg/kg daily in 24 divided doses increased to 150200 mg/kg daily in severe infections; child 100150 mg/kg daily in 24 divided doses increased up to 200mg/kg daily in very severe infections. Gonorrhoea, 500 mg as a single dose.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Most require dose adjustment in renal impairment (exceptions/nuances per agent — check SmPC).
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Usually low; transient LFT elevations possible.
Use, effects & interactions
Indications
- Septicaemia, meningitis in neonates and infants, peri-operative infections prophylaxis, UTI, RTI, bone, joints, skin and soft tissue infections.
- Clinical selection for Cefotaxime should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Beta-lactam antibiotic — cephalosporin.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- GI disturbances, allergic reactions, blood dyscrasia, severe headaches, glossitis, pain at I.M injection site, pseudomembranous entero-colitis, oedema, genital tract mycosis, oliguria.
Drug interactions
Open multi-drug checker ↗- Choose generation by indication and resistance patterns.
- Prefer narrowest effective spectrum.
- IV-to-oral switch when clinically stable.
- Align duration with guidelines (often shorter than historical practice for many infections).
Mechanism & disposition
Inhibits synthesis of bacterial cell wall, causing cell death, hence bactericidal.
Read complete mechanism
Inhibits synthesis of bacterial cell wall, causing cell death, hence bactericidal. Cephalosporins inhibit bacterial cell-wall synthesis by binding PBPs and blocking peptidoglycan cross-linking, producing bactericidal activity against susceptible organisms. Spectrum broadens from 1st to later generations; stability to beta-lactamases varies.
Rapid (IV); 1–2 h oral
6–24 hours (agent-dependent; ceftriaxone long)
INTRAMUSCULAR, INTRAVENOUS
into tissues good; CSF penetration generation- and inflammation-dependent (e.g. ceftriaxone/cefotaxime used in meningitis). Many cleared renally; ceftriaxone has dual renal/biliary
— caution in neonates with hyperbilirubinaemia.
Pregnancy, lactation & diet
Generally considered acceptable in pregnancy when indicated; prefer agents with established safety data.
Usually compatible; monitor infant for GI effects.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.