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Disclaimer to the On-line Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

CEFOTAXIME

Indication

  • cefotaxime is a 3rd generation cephalosporin antibiotic; it is used for the treatment of documented or suspected meningitis or septicemia due to susceptible organisms and for nonpseudomonal Gram-negative organisms (eg. E. coli, H. influenzae, Klebsiella) in patients in whom it is preferable not to use an aminoglycoside
  • it is advisable to add ampicillin to cover for the possible presence of Listeria or enterococcus (especially when treating neonates with possible meningitis)

Pharmacology

  • the antibacterial activity of cefotaxime results from the inhibition of bacterial cell wall synthesis
  • cefotaxime is partially metabolized to an active metabolite, desacetylcefotaxime

Side Effects

  • rare, but include hypersensitivity reactions (eg. rash, fever), GI effects (eg. vomiting, diarrhea), hematological effects (eg. neutropenia, thrombocytopenia), renal effects (transient increase in BUN and/or serum creatinine and transient increases in liver enzymes
  • superinfection, due to resistant bacteria or Candida, may occur

Dose

  • administer by slow IV infusion

    < 7 days of life:50 mg/kg IV q12h
    > 7 days of life:50 mg/kg IV q8h
    Meningitis:50 mg/kg IV q6h
  • COMPATIBLE WITH TPN AND LIPID

Supplied

  • 50 mg/mL syringe prepared by Pharmacy
  • available as a 1g vial; Reconstitute a 1000mg vial with 9.5mL of SWI, produces a 100mg/mL solution. Further dilute to a total volume of 20mL with D5W, resulting in a 50mg/mL solution.

References

  1. McEvoy G K (ed): AHFS Drug Information, American Society of Hospital Pharmacists, 1991.
  2. Krogh CME et al (ed): Compendium of Pharmaceuticals and Specialties, Canadian Pharmaceutical Association, 1992.
  3. Bhatt DR, Furman GI, Reber DJ et al: Neonatal Drug Formulary, 1990-1991, 2nd Edition, Fontana, California 92334.
  4. Taketomo CK, Hodding JH and Kraus DM: Pediatric Dosage Handbook, Lexi-Comp Inc., Cleveland, 1992.
  5. Young TE and Mangum OB: Neofax - A Manual of Drugs Used in Neonatal Care, Columbus, Ohio: Ross Laboratories, 1992.
  6. Kearns GL, Jacobs RF, Thomas BR et al: Cefotaxime and desacetylcefotaxime pharmacokinetcis in very low birth weight neonates, J Pediatr 1989; 114:461-467.

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