Antimicrobials
Cefotaxime

Cefotaxime

High
N/A
See below under General Info

Dosing

General Information

Hospital Formulary Status Yes (parenteral inj)

In-Hospital Cost will be updated

PharmaCare Formulary Status Yes (parenteral inj)

SA None

PharmaCare Coverage 1g powder for soln/inj - $8.9964/vial 2g powder for soln/inj - $18.0203/vial

Outpatient Cost 1g powder for soln/inj - $8.99-9.90/vial 2g powder for soln/inj - $18.02-19.82/vial

Empiric therapy for:

  •  Bacterial meningitis
  •  Pneumonia (in combination with a macrolide)
  •  Intra-abdominal infection including SBP
  •  Musculoskeletal i.e. septic arthritis
  •  Urinary tract infection

Acute liver injury (IV)

  • usually mild and self-limiting
  • involves cholestatic hepatitis and elevations in ALT, AST and alkaline phosphatase
  • liver failure is rare

Neutropenia (IV)

  • associated with immune-mediated destruction of polymorphonuclear leukocytes
  • sx: abrupt onset of fever, rash, and eosinophilia

Thrombocytopenia (IV)

  • acute immune-mediated
  • usually platelet count normalizes within 2 weeks after discontinuation

Allergic interstitial nephritis (IV)

  • sx: acute and often severe renal failure, with active urinary sediment (hematuria, proteinuria, and pyuria) but no red cell casts
  • usually signs of hypersensitivity are present (fever, peripheral eosinophilia, eosinophiluria and rash)
  • several cases of cross-sensitivity between beta-lactam antibiotics

Pulmonary infiltrate with eosinophilia (PIE) syndrome (IV)

  • sx: abrupt onset of fever, chills, dyspnea, pulmonary infiltrates and peripheral eosinophilia

CNS toxicity (IV)

  • sx: seizures
  • has less convulsant properties than penicillin

Allergic reaction (IV)

  • IgE-mediated
  • sx: pruritus, flushing, urticaria, angioedema, wheezing, laryngeal edema, hypotension, and/or anaphylaxis
  • sx usually appear within 4 hrs of administration but may begin within mins

Serum sickness (IV)

  • late allergic reaction
  • sx: fever, rash, adenopathy, arthritis and glomerulonephritis
  • associated with circulating immune complexes

Rash (IV)

  • includes morbilliform rash, erythema multiforme, SJS, exfoliative dermatitis, toxic epidermal necrolysis and vasculitis
  • sx: photosensitivity, skin lesions, mucosal membrane ulceration, erythema, scaling, palpable purpura and/or positive Nikolsky's sign

Note: EBV-related rash - not an allergy

  • morbilliform rash, occurring 48 hrs to weeks after initial amoxicillin exposure in patients with Epstein Barr Virus, does not appear to be a true drug allergy

Antimicrobial class: 3rd Generation Cephalosporin

Pregnancy category: B

Average serum half life: 1.5 hr

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Biliary penetration: Moderate