Cefotaxime/Claforan



- 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.


Cefotaxime vs nafcillin and tobramycin for the treatment of serious infection. Comparative cost-effectiveness.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, November 30, 2012 3:06 pm