Description and indication for use
Cefotaxime is a semisynthetic,
third-generation cephalosporin. It is
active against both Gram +ve and Gram -ve organisms. It is used in the treatment of infection when
sensitivity testing indicates susceptibility.
It is combined with Amoxycillin for treatment of meningitis until the organism
is identified and sensitivity is confirmed.
Dose
IV and IM:
50 mg/kg/dose.
| VLBW | 12 hourly |
| Term | |
| Week 1 | 12 hourly |
| Week 2 to 4 | 8 hourly |
| >4 weeks | 6 hourly |
Reconstitution/Dilution
Vial = 1g.
IV:
Add 9.6 mL of water for injection to vial = 1 g
in 10 mL is equivalent to 100 mg/mL.
May be further diluted with sodium chloride
0.9% to 50 mg/mL.
IM:
Add 3.6 mL of water for injection = 1 g in 4 mL is equivalent to 250 mg/mL.
Reconstituted solution is stable for 24
hours when stored under refrigeration.
Route and method of administration
IV:
100 mg/mL or 50 mg/mL solution given slowly
over at least 3-5 minutes.
IM:
250 mg/mL solution. Not
Recommended, but may be useful for larger babies with no IV access.
Side effects
Hypersensitivity (not commonly seen in
neonates).
Phlebitis.
Diarrhoea.
Nephrotoxicity
Leukopenia, eosinophilia, granulocytopaenia.
Special precautions
CAUTION in patients with renal impairment.
Contraindications
Hypersensitivity to cephalosporins.
Incompatibilities
Cefotaxime must not be mixed together with
the following drugs:
Sodium
bicarbonate, aminoglycosides (gentamicin, amikacin and tobramycin), doxapram, fluconazole,
aminophylline.
Drug interactions
| Aminoglycosides | Nephrotoxicity of both drugs may be increased. However, Cefotaxime is sometimes used together with Aminoglycosides as there is evidence of a synergistic effect when used in combination. Careful monitoring of Aminoglycoside levels should reduce incidence/severity of Nephrotoxicity. |
Nursing responsibilities
Observe site for phlebitis.
Record volume on IV fluid chart - large
volume drug.