Cefotaxime, 1 g

Cefotaxime is a III generation cephalosporin antibiotic for parenteral administration.

It acts bactericidally. The mechanism of action is associated with disruption of mucopeptide synthesis of the cell wall of microorganisms.

It has a wide range of antimicrobial action.

The drug is active against Gram-positive and Gram-negative microorganisms resistant to other antibiotics.

Resistant to most beta-lactamases of gram-positive and gram-negative microorganisms.

Indications

– CNS infections (meningitis).
– Infections of the respiratory tract and ENT organs.
– Infections of the urinary tract.
– Bone and joint infections.
– Skin and soft tissue infections.
– Infections of pelvic organs.
– Abdominal infections.
– Peritonitis.
– Sepsis.
– Endocarditis.
– Gonorrhea
– Infected wounds and burns.
– Salmonellosis.
– Lyme disease.
– Infections against the background of immune deficiency.
– Prophylaxis of infections after surgical operations (including urological, obstetrical and gynecological and gastrointestinal diseases).

Active ingredient

Composition

In 1 vial of powder for preparation of a solution for intravenous and intravenous administration it contains:

cefotaxime (in the form of sodium salt) 1 g.

Powder for preparation of a solution for intravenous and intravenous administration.

How to take, the dosage

The drug is administered intravenously (by trickle or drop) and intravenously. The drug is administered to adults and children over 12 years of age (with body weight ≥50 kg)

In uncomplicated infections as well as in urinary tract infections: intravenously or intravenously 1 g every 8-12 hours.
In uncomplicated acute gonorrhea: in/m in a dose of 1 g once.

Infections of moderate severity: in/m or intravenously in a dose of 1-2 g every 12 hours.

In case of severe infections, e.g. meningitis: by 2 g every 4-8 hours, maximum daily dose – 12 g. The duration of treatment is determined individually.

In order to prevent development of infections before surgical operation: administered once in a dose of 1 g during induction anesthesia. If necessary the preparation is repeated in 6-12 hours.

In caesarean section: at the moment of application of clamps on the umbilical vein it is administered by injection in a dose of 1 g and then in 6 and 12 hours after the first dose – 1 g additionally.

In case of renal dysfunction: in IQ ≤20 ml/min/1.73 m2 the daily dose is reduced twice.

Preterm and newborns before 1 week of age – i.v. in dose 50 mg/kg every 12 hours; in children aged 1-4 weeks – i.v. in dose 50 mg/kg every 8 hours. In children with body weight ≤50 kg – by IV or IM (children over 2.5 years of age) 50-180 mg/kg in 4-6 injections. In case of severe infections (including meningitis) daily dose for children is increased to 100-200 mg/kg, i/m or i/v in 4-6 injections, maximum daily dose – 12 g.

The rules for preparation of injection solutions:

For IV injection: 1 g of the drug is diluted in 4 ml of sterile water for injection; the drug is administered slowly for 3-5 min.
For intravenous infusion: 1-2 g of the drug are diluted in 50-100 ml of solvent. 0.9% sodium chloride solution or 5% dextrose (glucose) solution is used as a solvent. The duration of infusion is 50-60 minutes.

Injection into the body: 1 g is dissolved in 4 ml of solvent. Water for injection or 1% lidocaine solution is used as a solvent.

Interaction

Cefotaxime increases the risk of bleeding when combined with antiaggregants, NSAIDs. The risk of renal damage increases with concomitant use of aminoglycosides, polymyxin B and “loop” diuretics.

Drugs that block tubular secretion increase plasma concentrations of cefotaxime and slow its excretion. Pharmaceutically incompatible with solutions of other antibiotics in the same syringe or dropper.

Special Instructions

In the first weeks of treatment, pseudomembranous colitis may occur, manifesting as severe prolonged diarrhea. In this case the drug is discontinued and adequate therapy including vancomycin or metronidazole is prescribed.

Patients with a history of allergic reactions to penicillins may have hypersensitivity to cephalosporin antibiotics. During treatment with the drug for more than 10 days peripheral blood count should be monitored. False positive Coombs test and false positive urine glucose reaction are possible during treatment with cefotaxime.

When treating it is impossible to drink alcohol because the effects similar to those of disulfiram are possible (facial hyperemia, abdominal and stomach cramps, nausea, vomiting, headache, BP decrease, tachycardia, shortness of breath).

Contraindications

– Pregnancy.
– Children under 2.5 years of age (for intravenous administration).
– Hypersensitivity (including to penicillins, other cephalosporins, carbapenems).
The drug should be used with caution:
– In infants.
– During lactation (in small concentrations is excreted with breast milk).
– In chronic renal insufficiency.
– In UC (including in anamnesis).

Side effects

CNS disorders: headache, dizziness.

Urinary system disorders: renal dysfunction, oliguria, interstitial nephritis.

Digestive system disorders: nausea, vomiting, diarrhea or constipation, flatulence, abdominal pain, dysbacteriosis, liver function disorders; rarely – stomatitis, glossitis, pseudomembranous enterocolitis, increased liver transaminases and alkaline phosphate activity, hyperbilirubinemia.

Hematopoietic disorders: hemolytic anemia, leukopenia, neutropenia, granulocytopenia, thrombocytopenia, agranulocytosis, hypocoagulation.

Cardiovascular system disorders: potentially life-threatening arrhythmias after rapid bolus injection into the central vein.

Laboratory parameters: azotemia, increased blood urea concentration, hypercreatininemia, positive Coombs reaction.

Local reactions: phlebitis, soreness along the vein, soreness and infiltration at the site of injection.

Allergic reactions: urticaria, chills or fever, rash, skin itching; rarely – bronchospasm, eosinophilia, erythema malignant exudative (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell syndrome), angioedema, anaphylactic shock.

Others: superinfection (vaginal and oral candidiasis).

Overdose

Symptoms: convulsions, encephalopathy (in case of administration in high doses, especially in patients with renal failure), tremor, neuromuscular excitability.

Treatment: symptomatic, no specific antidote.

Similarities