Third-generation parenteral cephalosporin indicated for serious infections due to susceptible organisms: respiratory, urinary, gynecologic, septicemia, endocarditis, meningitis and intra-abdominal infections.
Also known as: Cefotaxima, Claforan
DailyMed approved label (Cefotaxime Injection; setID 8efe3bd0-c43a-2bd6-e053-2a95a90a92fa).
DailyMed approved label (Cefotaxime Injection; setID 8efe3bd0-c43a-2bd6-e053-2a95a90a92fa).
Cefotaxime + probenecid: probenecid inhibits cephalosporin tubular secretion — raises serum concentrations.
The Prontuário Terapêutico documents in the cephalosporin introduction (1.1.2): "Probenecid competitively inhibits the tubular secretion of most cephalosporins, causing a significant increase in their serum concentrations". Cefotaxime is excreted by renal tubular secretion, so probenecid raises and prolongs its plasma concentrations. Although the combination was historically used to prolong antibiotic levels, it is not recommended in current practice — the increased exposure may potentiate dose-dependent adverse effects, including neurotoxicity in the elderly and renally impaired. The practical guidance is to avoid the combination; if probenecid is essential, consider reducing the cefotaxime dose and monitor for signs of toxicity.
Cefotaxime + probenecid: probenecid inhibits cephalosporin tubular secretion — raises serum concentrations.
The Prontuário Terapêutico documents in the cephalosporin introduction (1.1.2): "Probenecid competitively inhibits the tubular secretion of most cephalosporins, causing a significant increase in their serum concentrations". Cefotaxime is excreted by tubular secretion — probenecid raises and prolongs its concentrations.
Monitor for signs of toxicity if the combination is used.
Increased adverse effects or neurotoxicity with the combination.
Avoid the combination; if probenecid is essential, consider reducing the cefotaxime dose.
Prontuário Terapêutico do INFARMED (11th ed., 2012) — Cephalosporins, 1.1.2 ; approved Probenecid label (MARLEX): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5d552de5-2d18-4464-bcaf-0311fa3f080d
Cefotaxime is given intravenously or intramuscularly; food does not affect its pharmacokinetics.
May be administered regardless of meals.
DailyMed/FDA (NIH/NLM) — approved Cefotaxime Injection label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8efe3bd0-c43a-2bd6-e053-2a95a90a92fa
No relevant pharmacokinetic interaction with cefotaxime.
Moderate alcohol intake.
DailyMed/FDA (NIH/NLM) — approved Cefotaxime Injection label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8efe3bd0-c43a-2bd6-e053-2a95a90a92fa
Cefotaxime is contraindicated in patients with documented cephalosporin allergy (risk of anaphylaxis).
Confirm allergy history before administering.
DailyMed/FDA (NIH/NLM) — approved Cefotaxime Injection label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8efe3bd0-c43a-2bd6-e053-2a95a90a92fa
Cefotaxime is eliminated renally; renal impairment requires dose adjustment.
Adjust the dose based on renal function.
DailyMed/FDA (NIH/NLM) — approved Cefotaxime Injection label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8efe3bd0-c43a-2bd6-e053-2a95a90a92fa
Cephalosporins are considered safe in pregnancy; cefotaxime is used in maternal and neonatal infections.
May be used in any trimester when indicated.
Present in breast milk in small amounts; compatible with breastfeeding.
No specific contraception required.
DailyMed/FDA (NIH/NLM) — approved Cefotaxime Injection label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8efe3bd0-c43a-2bd6-e053-2a95a90a92fa
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Third-generation cephalosporin: time above the MIC correlates with efficacy. Good activity against Gram-negatives (including beta-lactamase-producing H. influenzae) and good CSF penetration with inflamed meninges.
Inhibition of cell-wall synthesis by binding to PBPs; stable to most plasmidial and chromosomal beta-lactamases.
After IM administration of 500 mg or 1 g, peak serum levels of 11.7 and 20.5 mcg/mL within ~30 min; after IV of 1 g, ~101.7 mcg/mL. No accumulation with repeated 1 g infusions every 6 h for 14 days.
~60% of the dose is recovered in urine within the first 6 hours; 20–36% excreted unchanged and 15–25% as desacetylcefotaxime (active metabolite). The desacetyl metabolite contributes to bactericidal activity.
Elimination half-life ~1 h.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
