Cefotaxime
⚠️ About 1–6% of penicillin-sensitive patients will also be allergic to cephalosporins.
❌ Those with a history of immediate hypersensitivity to penicillin or other beta-lactams should not receive cephalosporins.
⚠️ Cephalosporins should be used with caution in patients with any beta-lactam sensitivity.
📖 About
Always check the BNF link here.
- 💊 3rd Generation cephalosporin.
- 🦠 Excellent activity against Gram-negative bacilli.
- ⬇️ Reduced Gram-positive cover compared with 2nd generation cephalosporins.
⚙️ Action
- 🔗 Inhibits peptidoglycan cross-linking → prevents bacterial cell wall formation.
- 🦠 Bactericidal activity with good CSF penetration (useful in meningitis).
💉 Indications
- 🏥 Bacterial meningitis, septicaemia, pneumonia.
- 🧬 Gonorrhoea, biliary sepsis, peritonitis.
- 💧 UTIs and pyelonephritis.
- 📦 Uncomplicated gonorrhoea: 500 mg IM.
- ⚖️ Mild–moderate infection: 1 g IV/IM BD.
- 🔥 Severe infection: 2 g IV QDS (max 12 g/day).
- 🚑 Suspected meningitis pre-hospital (if IV benzylpenicillin unavailable): 1 g IV/IM.
📊 Dose Range (check BNF / datasheet)
| Indication | Dose | Frequency | Route |
|---|
| Moderate infection | 1 g | BD | IV / IM |
| Severe infection | 2 g | QDS | IV / IM |
🔄 Interactions
- ⚠️ May increase effect of warfarin → monitor INR closely.
⚠️ Cautions
- 🚫 Penicillin or cephalosporin allergy.
- 💧 Renal impairment (dose adjustment needed).
- 🧪 False positives: urine glucose dipstick, Coombs’ test.
- 💉 IV doses may be high in sodium or potassium.
⛔ Contraindications
- Severe hypersensitivity reactions to beta-lactams.
- Penicillin allergy (cross-sensitivity ~10%).
💥 Side Effects
- 🤢 GI: diarrhoea, antibiotic-associated colitis, nausea, vomiting.
- 🌡️ Allergic: rash, urticaria, Stevens–Johnson syndrome, TEN, anaphylaxis.
- 🧪 Hepatic: hepatitis, cholestatic jaundice.
- 🩸 Haematological: ↓ WCC, platelets, granulocytes, aplastic anaemia.
- 💧 Renal: interstitial nephritis.
- 🧠 CNS: headache, delirium.
- ⚡ Cardiac: arrhythmias with rapid IV injection.
📚 References
