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cefotaxime

Generic Name: cefotaxime (SEF oh TAX eem)
Brand Name: Claforan, Claforan ADD-Vantage

What is cefotaxime?

Cefotaxime is a cephalosporin (SEF a low spor in) antibiotic. It works by fighting bacteria in your body.

Cefotaxime is used to treat many kinds of bacterial infections, including severe or life-threatening forms. Cefotaxime is also used to prevent infections in people having surgery.

Cefotaxime may also be used for purposes not listed in this medication guide.

What is the most important information I should know about cefotaxime?

You should not use this medication if you are allergic to cefotaxime or to similar antibiotics, such as cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), and others.

What should I discuss with my health care provider before using cefotaxime?

You should not use this medicine if you are allergic to cefotaxime, or to other cephalosporin antibiotics, such as:

  • cefaclor (Raniclor);

  • cefadroxil (Duricef);

  • cefazolin (Ancef);

  • cefdinir (Omnicef);

  • cefditoren (Spectracef);

  • cefpodoxime (Vantin);

  • cefprozil (Cefzil);

  • ceftibuten (Cedax);

  • cefuroxime (Ceftin);

  • cephalexin (Keflex); or

  • cephradine (Velosef).

To make sure cefotaxime is safe for you, tell your doctor if you have:

  • an allergy to penicillin;

  • kidney disease;

  • liver disease;

  • a stomach or intestinal disorder such as colitis;

  • diabetes;

  • a heart rhythm disorder; or

  • if you also take furosemide.

This medicine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Cefotaxime can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use cefotaxime?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Cefotaxime is injected into a muscle or into a vein through an IV. It is sometimes given through a central IV line placed into a large vein in your chest. You may be shown how to use an IV at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of needles, IV tubing, and other items used.

Cefotaxime must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medication.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Cefotaxime will not treat a viral infection such as the flu or a common cold.

This medication can cause unusual results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using cefotaxime.

If your medicine is frozen when you receive it, keep it frozen until you are ready to use the medicine. It is best to store the medicine in a deep freezer at a temperature of 4 degrees below 0.

To use the medicine, thaw it in a refrigerator or at room temperature. Do not warm in a microwave or boiling water. Keep thawed medicine in the refrigerator and use it within 10 days after thawing it. Do not refreeze thawed medicine.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

If you are receiving this medicine at a clinic, call your doctor if you miss an appointment for your injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include weakness, cold feeling, pale skin, blue lips, or seizure (convulsions).

What should I avoid while using cefotaxime?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Cefotaxime side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe stomach pain, diarrhea that is watery or bloody;

  • skin rash, bruising, severe tingling, numbness, pain, muscle weakness;

  • seizure (black-out or convulsions); or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • pain, irritation, or a hard lump where the injection was given;

  • mild diarrhea;

  • fever; or

  • itching or mild skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Cefotaxime dosing information

Usual Adult Dose for Bacteremia:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Use: Treatment of bacteremia or septicemia caused by Escherichia coli, Klebsiella species, Serratia marcescens, Staphylococcus aureus, and Streptococcus species

Usual Adult Dose for Septicemia:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Use: Treatment of bacteremia or septicemia caused by Escherichia coli, Klebsiella species, Serratia marcescens, Staphylococcus aureus, and Streptococcus species

Usual Adult Dose for Sepsis:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Use: Treatment of bacteremia or septicemia caused by Escherichia coli, Klebsiella species, Serratia marcescens, Staphylococcus aureus, and Streptococcus species

Usual Adult Dose for Cesarean Section:

1 g IV as soon as the umbilical cord is clamped, then additional 1 g IM or IV doses at 6 and 12 hours after the initial dose

Use: To reduce the incidence of postoperative infections

Usual Adult Dose for Meningitis:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating Klebsiella pneumoniae and E coli have been studied in less than 10 infections.

Use: Treatment of central nervous system infections (including meningitis and ventriculitis) caused by Neisseria meningitides, Haemophilus influenzae, Streptococcus pneumoniae, K pneumoniae, and E coli

Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), American Association of Neurological Surgeons (AANS), and Neurocritical Care Society (NCS) Recommendations: 8 to 12 g per day, given at 4 to 6 hour intervals

Comment: Vancomycin should be added to isolates with a penicillin MIC of 0.12 mcg/mL or higher and a third-generation cephalosporin MIC of 1 mcg/mL or greater.

Uses:
-Treatment of healthcare-associated ventriculitis and meningitis caused by gram-negative bacilli susceptible to third-generation cephalosporins
-Recommended treatment of bacterial meningitis caused by N meningitides, H influenzae, S pneumoniae, and E coli
-Empirical antimicrobial therapy in patients 50 years and younger with purulent meningitis caused by N meningitides or S pneumoniae
-Empirical antimicrobial therapy in patients over 50 years of age with purulent meningitis caused by S pneumoniae, N meningitides, Listeria monocytogenes, or aerobic gram-negative bacilli
-Empirical antimicrobial therapy in patients with basilar skull fractures with purulent meningitis caused by S pneumoniae, H influenzae, Group A beta-hemolytic streptococci

Usual Adult Dose for CNS Infection:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating Klebsiella pneumoniae and E coli have been studied in less than 10 infections.

Use: Treatment of central nervous system infections (including meningitis and ventriculitis) caused by Neisseria meningitides, Haemophilus influenzae, Streptococcus pneumoniae, K pneumoniae, and E coli

Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), American Association of Neurological Surgeons (AANS), and Neurocritical Care Society (NCS) Recommendations: 8 to 12 g per day, given at 4 to 6 hour intervals

Comment: Vancomycin should be added to isolates with a penicillin MIC of 0.12 mcg/mL or higher and a third-generation cephalosporin MIC of 1 mcg/mL or greater.

Uses:
-Treatment of healthcare-associated ventriculitis and meningitis caused by gram-negative bacilli susceptible to third-generation cephalosporins
-Recommended treatment of bacterial meningitis caused by N meningitides, H influenzae, S pneumoniae, and E coli
-Empirical antimicrobial therapy in patients 50 years and younger with purulent meningitis caused by N meningitides or S pneumoniae
-Empirical antimicrobial therapy in patients over 50 years of age with purulent meningitis caused by S pneumoniae, N meningitides, Listeria monocytogenes, or aerobic gram-negative bacilli
-Empirical antimicrobial therapy in patients with basilar skull fractures with purulent meningitis caused by S pneumoniae, H influenzae, Group A beta-hemolytic streptococci

Usual Adult Dose for Pelvic Inflammatory Disease:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Efficacy in treating Enterobacter species, Klebsiella species, Bacteriodes fragilis, and Fusobacterium nucleatum have been studied in less than 10 infections.
-This drug is not active against Chlamydia trachomatis. Patients with pelvic inflammatory disease suspected to be caused by C trachomatis should be given appropriate anti-chlamydial treatment.

Use: Treatment of endometriosis, pelvic inflammatory disease, and pelvic cellulitis caused by Staphylococcus epidermidis, Streptococcus species, Enterococcus species, Enterobacter species, E coli, Klebsiella species, Proteus mirabilis, Bacteroides species, Clostridium species, anaerobic cocci (e.g., Peptostreptococcus species, Peptococcus species), and Fusobacterium species

Usual Adult Dose for Endometritis:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Efficacy in treating Enterobacter species, Klebsiella species, Bacteriodes fragilis, and Fusobacterium nucleatum have been studied in less than 10 infections.
-This drug is not active against Chlamydia trachomatis. Patients with pelvic inflammatory disease suspected to be caused by C trachomatis should be given appropriate anti-chlamydial treatment.

Use: Treatment of endometriosis, pelvic inflammatory disease, and pelvic cellulitis caused by Staphylococcus epidermidis, Streptococcus species, Enterococcus species, Enterobacter species, E coli, Klebsiella species, Proteus mirabilis, Bacteroides species, Clostridium species, anaerobic cocci (e.g., Peptostreptococcus species, Peptococcus species), and Fusobacterium species

Usual Adult Dose for Gonococcal Infection -- Uncomplicated:

Urethritis/cervicitis: 0.5 g IM once

Rectal gonorrhea:
-Females: 0.5 g IM once
-Males: 1 g IM once

Use: Treatment of uncomplicated cervical/urethral and rectal gonorrhea caused by Neisseria gonorrhoeae, including penicillinase producing strains

US Centers for Disease Control and Prevention (CDC) Recommendations:
Urogenital and anorectal infections: 500 mg IM once

Use: Alternative treatment of uncomplicated gonococcal infections of the cervix, urethra, and rectum

Usual Adult Dose for Intraabdominal Infection:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating Streptococcus species, Peptostreptococcus species, Pseudomonas aeruginosa, P mirabilis, and Clostridium species have been studied in less than 10 infections.

Use: Treatment of intraabdominal infections caused by Streptococcus species, E coli, Klebsiella species, Bacteroides species, anaerobic cocci, P mirabilis, and Clostridium species

IDSA and National Institutes of Health (NIH) Recommendations: 1 g IV every 8 hours

Uses:
-Empiric treatment of bacterial enteric infections for patients with advanced HIV and clinically severe diarrhea (e.g., 6 or more liquid stools/day or bloody stool and/or with fever/chills)
-Treatment of salmonellosis in patients with HIV

Surgical Infection Society (SIS) and IDSA Recommendations: 1 to 2 g IV every 6 to 8 hours PLUS metronidazole

Use: Empirical treatment of community-acquired mild-to-moderate perforated/abscessed appendicitis and other infections of mild-to-moderate severity

Usual Adult Dose for Joint Infection:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating Streptococcus pyogenes, P aeruginosa, and P mirabilis have been studied in less than 10 infections.

Use: Treatment of bone and/or joint infections caused by penicillinase and non-penicillinase producing S aureus, Streptococcus species, Pseudomonas species, and P mirabilis

Usual Adult Dose for Osteomyelitis:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating Streptococcus pyogenes, P aeruginosa, and P mirabilis have been studied in less than 10 infections.

Use: Treatment of bone and/or joint infections caused by penicillinase and non-penicillinase producing S aureus, Streptococcus species, Pseudomonas species, and P mirabilis

Usual Adult Dose for Peritonitis:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating Streptococcus species, Peptostreptococcus species, P aeruginosa, P mirabilis, and Clostridium species have been studied in less than 10 infections.

Use: Treatment of peritonitis caused by Streptococcus species, E coli, Klebsiella species, Bacteroides species, anaerobic cocci, P mirabilis, and Clostridium species

International Society for Peritoneal Dialysis (ISPD) Recommendations:
Intermittent: 500 to 1000 mg intraperitoneally once a day

Use: Empirical treatment of peritonitis suspected to be caused by gram-negative organisms

Usual Adult Dose for Pneumonia:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating S pyogenes and S marcescens have been studied in less than 10 infections.

Use: Treatment of serious lower respiratory tract infections (including pneumonia) caused by S pneumoniae/Diplococcus pneumoniae, S pyogenes (Group A streptococci), other streptococci (except enterococci), penicillinase/non-penicillinase producing S aureus, E coli, Klebsiella species, H influenzae (including ampicillin-resistant organisms), Haemophilus parainfluenzae, P mirabilis, S marcescens, Enterobacter species, and indole positive Proteus and Pseudomonas species

Usual Adult Dose for Skin or Soft Tissue Infection:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating Acinetobacter species, Citrobacter freundii, Proteus vulgaris, Providencia rettgeri, and Peptostreptococcus have been studied in less than 10 infections.

Use: Treatment of skin and structure infections caused by penicillinase and non-penicillinase producing S aureus, Staphylococcus epidermidis, Streptococcus pyogenes (Group A streptococci), other streptococci, Enterococcus species, Acinetobacter species, E coli, Citrobacter species, Enterobacter species, Klebsiella species, P mirabilis, P vulgaris, Morganella morganii, P rettgeri, Pseudomonas species, S marcescens, Bacteroides species, and anaerobic cocci

IDSA Recommendations:
Animal bites: 1 to 2 g IV every 6 to 8 hours
Mixed infections: 2 g IV every 6 hours PLUS metronidazole or clindamycin
Vibrio infections: 2 g IV 3 times a day PLUS doxycycline

Uses:
-Treatment of necrotizing infections of the skin, fascia, and muscle caused by mixed infections or Vibrio vulnificus
-Treatment of infections following animal bites

Usual Adult Dose for Surgical Prophylaxis:

1 g IM or IV once

Comments:
-This drug should be given 30 to 90 minutes prior to surgery.
-Some experts recommend preoperative bowel preparation with mechanical cleansing and use of a non-absorbable antibiotic in patients undergoing gastrointestinal procedures.

Use: To reduce the incidence of specific infections in patients undergoing contaminated or possibly contaminated surgical procedures (e.g., abdominal/vaginal hysterectomy, gastrointestinal/genitourinary tract surgery)

American Society of Health-System Pharmacists (ASHP), IDSA, SIS, and Society for Healthcare Epidemiology of America (SHEA) Recommendations:
Non-obese patients: 1 g IV once PLUS ampicillin
Obese patients: 2 g IV once PLUS ampicillin

Comment: The recommended redosing interval is 3 hours.

Use: Surgical antimicrobial prophylaxis in patients undergoing liver transplantation

Usual Adult Dose for Urinary Tract Infection:

Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Efficacy in treating S aureus, P vulgaris, M morganii, and P rettgeri have been studied in less than 10 infections.

Use: Treatment of urinary tract infections caused by Enterococcus species, S epidermidis, penicillinase/non-penicillinase producing S aureus, Citrobacter species, Enterobacter species, E coli, Klebsiella species, P mirabilis, P vulgaris, P stuartii, M morganii, P rettgeri, S marcescens, and Pseudomonas species

Usual Adult Dose for Gonococcal Infection -- Disseminated:

US CDC Recommendations: 1 g IV every 8 hours

Comment: The patient's sexual partner(s) within the past 60 days should be evaluates/treated.

Use: Alternative treatment of arthritis and arthritis-dermatitis syndrome caused by N gonorrhoeae

Usual Adult Dose for Lyme Disease -- Neurologic:

AAN and IDSA Recommendations: 2 g IV every 8 hours
-Duration of therapy: 14 to 28 days

Use: Treatment of nervous system Lyme disease

Usual Adult Dose for Sinusitis:

IDSA Recommendations: 2 g IV every 4 to 6 hours

Uses: Treatment of severe acute bacterial rhinosinusitis requiring hospitalization

Usual Adult Dose for Rhinitis:

IDSA Recommendations: 2 g IV every 4 to 6 hours

Uses: Treatment of severe acute bacterial rhinosinusitis requiring hospitalization

Usual Pediatric Dose for Bacteremia:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Higher doses should be used to treat more severe/serious infections.

Use: Treatment of bacteremia or septicemia caused by E coli, Klebsiella species, S marcescens, S aureus, and Streptococcus species

IDSA Recommendations:
Neonates 0 to 4 weeks and less than 1200 g: 100 mg/kg IV per day, given in divided doses every 12 hours
Postnatal age 7 days or less and 1200 to 2000 g: 100 mg/kg IV per day, given in divided doses every 12 hours
Postnatal age 7 days or less and greater than 2000 g: 100 to 150 mg/kg IV per day, given in divided doses every 8 to 12 hours
Postnatal age over 7 days and 1200 to 2000 g: 150 mg/kg IV per day, given in divided doses every 8 hours
Postnatal age over 7 days and over 2000 g: 150 to 200 mg/kg IV per day, given in divided doses every 6 to 8 hours
Infants and children 12 years and younger: 100 to 150 mg/kg per day, given in divided doses every 8 hours

Use: Treatment of catheter-related infections

Usual Pediatric Dose for Septicemia:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Higher doses should be used to treat more severe/serious infections.

Use: Treatment of bacteremia or septicemia caused by E coli, Klebsiella species, S marcescens, S aureus, and Streptococcus species

IDSA Recommendations:
Neonates 0 to 4 weeks and less than 1200 g: 100 mg/kg IV per day, given in divided doses every 12 hours
Postnatal age 7 days or less and 1200 to 2000 g: 100 mg/kg IV per day, given in divided doses every 12 hours
Postnatal age 7 days or less and greater than 2000 g: 100 to 150 mg/kg IV per day, given in divided doses every 8 to 12 hours
Postnatal age over 7 days and 1200 to 2000 g: 150 mg/kg IV per day, given in divided doses every 8 hours
Postnatal age over 7 days and over 2000 g: 150 to 200 mg/kg IV per day, given in divided doses every 6 to 8 hours
Infants and children 12 years and younger: 100 to 150 mg/kg per day, given in divided doses every 8 hours

Use: Treatment of catheter-related infections

Usual Pediatric Dose for Sepsis:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comment: Higher doses should be used to treat more severe/serious infections.

Use: Treatment of bacteremia or septicemia caused by E coli, Klebsiella species, S marcescens, S aureus, and Streptococcus species

IDSA Recommendations:
Neonates 0 to 4 weeks and less than 1200 g: 100 mg/kg IV per day, given in divided doses every 12 hours
Postnatal age 7 days or less and 1200 to 2000 g: 100 mg/kg IV per day, given in divided doses every 12 hours
Postnatal age 7 days or less and greater than 2000 g: 100 to 150 mg/kg IV per day, given in divided doses every 8 to 12 hours
Postnatal age over 7 days and 1200 to 2000 g: 150 mg/kg IV per day, given in divided doses every 8 hours
Postnatal age over 7 days and over 2000 g: 150 to 200 mg/kg IV per day, given in divided doses every 6 to 8 hours
Infants and children 12 years and younger: 100 to 150 mg/kg per day, given in divided doses every 8 hours

Use: Treatment of catheter-related infections

Usual Pediatric Dose for Meningitis:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating K pneumoniae and E coli have been studied in less than 10 infections.

Use: Treatment of central nervous system infections (including meningitis and ventriculitis) caused by N meningitides, H influenzae, S pneumoniae, K pneumoniae, and E coli

IDSA, AAN, AANS, and NCS Recommendations:
Bacterial meningitis:
0 to 7 days: 100 to 150 mg/kg IV per day, given in divided doses every 8 to 12 hours PLUS ampicillin
8 to 28 days: 150 to 200 mg/kg IV per day, given in divided doses every 6 to 8 hours PLUS ampicillin
Infants and children: 225 to 300 mg/kg IV per day, given in divided doses every 6 to 8 hours PLUS vancomycin

Nosocomial meningitis:
Children: 300 mg/kg IV per day, given at 6 to 8 hour intervals

Comment: Vancomycin should be added to patients over 1 month of age and/or in isolates with a penicillin MIC of 0.12 mcg/mL or higher and a third-generation cephalosporin MIC of 1 mcg/mL or greater.

Uses:
-Empirical antimicrobial therapy in patients less than 1 month of age with purulent meningitis caused by S agalactiae, E coli, L monocytogenes, or Klebsiella species
-Empirical antimicrobial therapy in patients 1 to 23 months of age with purulent meningitis caused by S pneumoniae, N meningitides, S agalactiae, H influenzae, or E coli
-Empirical antimicrobial therapy in patients 2 years and older with purulent meningitis caused by N meningitides or S pneumoniae
-Empirical antimicrobial therapy in patients with basilar skull fractures with purulent meningitis caused by S pneumoniae, H influenzae, Group A beta-hemolytic streptococci

Usual Pediatric Dose for CNS Infection:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating K pneumoniae and E coli have been studied in less than 10 infections.

Use: Treatment of central nervous system infections (including meningitis and ventriculitis) caused by N meningitides, H influenzae, S pneumoniae, K pneumoniae, and E coli

IDSA, AAN, AANS, and NCS Recommendations:
Bacterial meningitis:
0 to 7 days: 100 to 150 mg/kg IV per day, given in divided doses every 8 to 12 hours PLUS ampicillin
8 to 28 days: 150 to 200 mg/kg IV per day, given in divided doses every 6 to 8 hours PLUS ampicillin
Infants and children: 225 to 300 mg/kg IV per day, given in divided doses every 6 to 8 hours PLUS vancomycin

Nosocomial meningitis:
Children: 300 mg/kg IV per day, given at 6 to 8 hour intervals

Comment: Vancomycin should be added to patients over 1 month of age and/or in isolates with a penicillin MIC of 0.12 mcg/mL or higher and a third-generation cephalosporin MIC of 1 mcg/mL or greater.

Uses:
-Empirical antimicrobial therapy in patients less than 1 month of age with purulent meningitis caused by S agalactiae, E coli, L monocytogenes, or Klebsiella species
-Empirical antimicrobial therapy in patients 1 to 23 months of age with purulent meningitis caused by S pneumoniae, N meningitides, S agalactiae, H influenzae, or E coli
-Empirical antimicrobial therapy in patients 2 years and older with purulent meningitis caused by N meningitides or S pneumoniae
-Empirical antimicrobial therapy in patients with basilar skull fractures with purulent meningitis caused by S pneumoniae, H influenzae, Group A beta-hemolytic streptococci

Usual Pediatric Dose for Intraabdominal Infection:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating Streptococcus species, Peptostreptococcus species, P aeruginosa, P mirabilis, and Clostridium species have been studied in less than 10 infections.

Use: Treatment of peritonitis caused by Streptococcus species, E coli, Klebsiella species, Bacteroides species, anaerobic cocci, P mirabilis, and Clostridium species

IDSA and NIH Recommendations:
Adolescents: 1 g IV every 8 hours

Uses:
-Empiric treatment of bacterial enteric infections for patients with advanced HIV and clinically severe diarrhea (e.g., 6 or more liquid stools/day or bloody stool and/or with fever/chills)
-Treatment of salmonellosis in patients with HIV

Surgical Infection Society (SIS) and Infectious Diseases Society of America (IDSA) Recommendations: 150 to 200 mg/kg IV per day, given in divided doses every 6 to 8 hours

Use: Empirical treatment of community-acquired infections

Usual Pediatric Dose for Joint Infection:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating S pyogenes, P aeruginosa, and P mirabilis have been studied in less than 10 infections.

Use: Treatment of bone and/or joint infections caused by penicillinase and non-penicillinase producing S aureus, Streptococcus species, Pseudomonas species, and P mirabilis

Usual Pediatric Dose for Osteomyelitis:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating S pyogenes, P aeruginosa, and P mirabilis have been studied in less than 10 infections.

Use: Treatment of bone and/or joint infections caused by penicillinase and non-penicillinase producing S aureus, Streptococcus species, Pseudomonas species, and P mirabilis

Usual Pediatric Dose for Peritonitis:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating Streptococcus species, Peptostreptococcus species, P aeruginosa, P mirabilis, and Clostridium species have been studied in less than 10 infections.

Use: Treatment of peritonitis caused by Streptococcus species, E coli, Klebsiella species, Bacteroides species, anaerobic cocci, P mirabilis, and Clostridium species

ISPD Recommendations:
Continuous peritoneal dialysis:
-Loading dose: 500 mg/L intraperitoneally once
-Maintenance dose: 250 mg/L intraperitoneally

Intermittent peritoneal dialysis: 30 mg/kg intraperitoneally once a day
-Duration of therapy: 2 weeks

Comments:
-Patients receiving continuous dialysis should allow the loading dose to dwell for 3 to 6 hours.
-Patients receiving intermittent dialysis should be given the dose once a day in the long dwell.

Use: Treatment of peritonitis caused by E coli or Klebsiella species

Usual Pediatric Dose for Pneumonia:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating S pyogenes and S marcescens have been studied in less than 10 infections.

Use: Treatment of serious lower respiratory tract infections (including pneumonia) caused by S pneumoniae/D pneumoniae, S pyogenes (Group A streptococci), other streptococci (except enterococci), penicillinase/non-penicillinase producing S aureus, E coli, Klebsiella species, H influenzae (including ampicillin-resistant organisms), H parainfluenzae, P mirabilis, S marcescens, Enterobacter species, and indole positive Proteus and Pseudomonas species

IDSA and NIH Recommendations:
Children: 40 to 50 mg/kg IV 4 times a day OR 50 to 65 mg/kg IV 3 times a day
-Maximum dose: 8 to 10 g/day

Use: Treatment of bacterial pneumonia caused by S pneumoniae, S aureus, H influenzae, or P aeruginosa in patients exposed to or with HIV

Pediatric Infectious Diseases Society (PIDS) and IDSA Recommendations:
Older than 3 months: 150 mg/kg IV per day, given in divided doses every 8 hours

Uses:
-Preferred treatment of community-acquired pneumonia caused by H influenzae types A to
F or non-typeable
-Alternative treatment of community-acquired pneumonia caused by Group A Streptococcus or S pneumoniae with penicillin MICs of 2 mcg/mL or less

Usual Pediatric Dose for Skin or Soft Tissue Infection:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating Acinetobacter species, C freundii, P vulgaris, P rettgeri, and Peptostreptococcus have been studied in less than 10 infections.

Use: Treatment of skin and structure infections caused by penicillinase and non-penicillinase producing S aureus, S epidermidis, S pyogenes (Group A streptococci), other streptococci, Enterococcus species, Acinetobacter species, E coli, Citrobacter species, Enterobacter species, Klebsiella species, P mirabilis, P vulgaris, M morganii, P rettgeri, Pseudomonas species, S marcescens, Bacteroides species, and anaerobic cocci

IDSA Recommendations:
Children: 50 mg/kg IV per day, given in divided doses every 6 hours PLUS metronidazole or clindamycin

Use: Treatment of necrotizing infections of the skin, fascia, and muscle caused by mixed infections

Usual Pediatric Dose for Urinary Tract Infection:

0 to 1 week: 50 mg/kg IV every 12 hours
1 to 4 weeks: 50 mg/kg IV every 8 hours

1 month to 12 years:
Less than 50 kg: 50 to 180 mg/kg IM or IV per day, given in 4 to 6 equal doses
50 kg or more:
-Uncomplicated infections: 1 g IM or IV every 12 hours
-Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
-Infections needing higher-doses: 2 g IV every 6 to 8 hours
-Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

12 years and older:
Uncomplicated infections: 1 g IM or IV every 12 hours
Moderate to severe infections: 1 to 2 g IM or IV every 8 hours
Infections needing higher-doses: 2 g IV every 6 to 8 hours
Life-threatening infections: 2 g IV every 4 hours
Maximum dose: 12 g/day

Comments:
-Higher doses should be used to treat more severe/serious infections.
-Efficacy in treating S aureus, P vulgaris, M morganii, and P rettgeri have been studied in less than 10 infections.

Use: Treatment of urinary tract infections caused by Enterococcus species, S epidermidis, penicillinase/non-penicillinase producing S aureus, Citrobacter species, Enterobacter species, E coli, Klebsiella species, P mirabilis, P vulgaris, P stuartii, M morganii, P rettgeri, S marcescens, and Pseudomonas species

Usual Pediatric Dose for Surgical Prophylaxis:

ASHP, IDSA, SIS, and SHEA Recommendations:
Pediatric patients: 50 mg/kg IV once PLUS ampicillin
-Maximum dose: 1 g/dose

Comment: The recommended redosing interval is 3 hours.

Use: Surgical antimicrobial prophylaxis in patients undergoing liver transplantation

Usual Pediatric Dose for Gonococcal Infection -- Uncomplicated:

US CDC Recommendations:
Adolescents:
Urogenital and anorectal infections: 500 mg IM once

Use: Alternative treatment of uncomplicated gonococcal infections of the cervix, urethra, and rectum

Usual Pediatric Dose for Gonococcal Infection -- Disseminated:

US CDC Recommendations:
Neonates: 25 mg/kg IM or IV every 12 hours
Duration of therapy:
-Disseminated gonococcal infection (DGI): 7 days
-DGI with meningitis: 10 to 14 days

Adolescents: 1 g IV every 8 hours

Comments:
-The patient's sexual partner(s) within the past 60 days should be evaluates/treated.
-Treatment should be used with caution in infants with hyperbilirubinemia.

Uses:
-Treatment of DGI and gonococcal scalp abscesses
-Alternative treatment of arthritis and arthritis-dermatitis syndrome caused by N gonorrhoeae

Usual Pediatric Dose for Lyme Disease -- Neurologic:

AAN and IDSA Recommendations:
Pediatric patients: 150 to 200 mg/kg IV per day, given in 3 to 4 divided doses
-Maximum dose: 6 g/day
-Duration of therapy: 14 to 28 days

Use: Treatment of nervous system Lyme disease

Usual Pediatric Dose for Sinusitis:

IDSA Recommendations:
Children: 100 to 200 mg/kg IV per day, given in divided doses every 6 hours

Use: Treatment of severe acute bacterial rhinosinusitis requiring hospitalization

Usual Pediatric Dose for Rhinitis:

IDSA Recommendations:
Children: 100 to 200 mg/kg IV per day, given in divided doses every 6 hours

Use: Treatment of severe acute bacterial rhinosinusitis requiring hospitalization

What other drugs will affect cefotaxime?

Cefotaxime can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Other drugs may interact with cefotaxime, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about cefotaxime.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.02.

Date modified: December 03, 2017
Last reviewed: April 05, 2017

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