-
Third Generation Cephalosporin
- 100-200mg/kg/24hr; 1-2gm IV q4-6hr;
- good Gm Neg coverage; Broad spectrum Gm Neg and Pos;
- Treatment of
gonorrhea: 1gm IV single dose;
- Uncomplicated infections: 1gm IV/IM q12hr;
- Moderate to severe infections:1-2gm IV/IM q8hr;
- Septicemia and life threatening infections: 2gm IV q4hr;
- Prevention of postoperative infections: single 1gm IV/IM dose 30-90
min before start of surgery;
- Must decrease dose with renal failure;
- Caution w/ penicillin allergy, GI colitis, and contraindicated w/
cephalosporin allergy;
- Good diffusion from blood into CSF only with inflammation;
Ratio of CSF to Blood Level (%): Normal Meninges: < 1;
Inflammed Meninges: 6-16;
- Dosing Regimens for Patients with Renal Insufficiency: (Dose for 70kg
Adult {gm/dosing interval in hours}):CrCl: >80::1/6-8;;
CrCl:50-79::1/6-8;; CrCl:30-49::1/6-8;; CrCl:10-29::1/8-12;;
- 60 % of dose will be excreted in urine;
- Peds: 100-250 mg/kg/day q6hr;
- Cefotaxime:
- adds nothing to coverage provided by first-generation cephalosporins
against gram-positive cocci;
- because of its resistance to beta-lactamases, it provides potent broad
spectrum of activity against aerobic gram-negative bacteria that is
markedly > that provided by first- and second-generation agents;
- inhibits more than 90 % of strains of
Enterobacteriaceae, including
those producing beta-lactamase & those resistant to
aminoglycosides;
- majority of strains of
E. coli, proteus, and
Klebsiella are
inhibited by less/= 0.5 microgram per milliliter;
- Serratia marcescens,
Enterobacter sp. cloacae, and
Acinetobacter
show variable susceptibility, and strains of
P. aeruginosa are resistant;
- cefotaxime has only moderate activity against anaerobes and is
inferior to
Cefoxitin against most species.
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Cefotaxime vs nafcillin and tobramycin for the treatment of serious
infection. Comparative cost-effectiveness.
