General Information

Administration IM

  • Inject deep IM into large muscle mass
  • Individual 2g doses may be given if divided and administered in different IM sites Intravenous
  • IV bolus over at least 3-5 minutes
  • Infusion over 15-30 minutes

Preparation IM

  • Reconstitute vial with SWFI or bacteriostatic water
  • Use 2mL diluent for 500mg vial (230mg/mL concentration) and 3mL for the 1g vial (300mg/mL)
  • Shake to dissolve Intravenous
  • Reconstitute vials with 10mL or more SWFI
  • Concentration of vials: 50mg/mL (500mg vial), 95mg/mL (1g vial) and 180mg/mL (2g vial)
  • Shake to dissolve
  • Further dilute up to 1,000mL in NS, D5W, D10W, D5NS, D5(1/2)NS, D5(1/4)NS or LR


  • D5W, LR, NS

Empiric therapy for:

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

Tier 1 Protected Antimicrobial

  • Narrow spectrum, possible transition for discharge, IV to PO
  • Strategy: Total EBM duration set (inpatient and outpatient)
  • CBC with differential, especially if duration of at least 10 days
  • Renal function
  • Rash
  • Localized phlebitis at injection site
  • Allergy
  • Positive Coombs test
  • Neutropenia
  • Abnormalities in liver enzymes
  • Diarrhea
  • CDI
  • Probenecid: may increase [Cefotaxime]
  • Aminoglycosides: nephrotoxic effects of AGs enhanced by cephalosporins
  • Vitamin K Antagonists: may enhance anticoagulation effect of warfarin

Antimicrobial class: 3rd Generation Cephalosporin

Pregnancy category: B

Average serum half life: 1.5 hours

  • Infants 1500g or less: 4.6 hours
  • Infants >1500g: 3.4 hours

Urine penetration: Therapeutic, 60% of active drug is excreted into urine

Lung penetration: Therapeutic

CSF penetration: Therapeutic, best penetration when meninges are inflamed

Biliary penetration: Moderate

Bone penetration: Therapeutic

Prostatic penetration: Therapeutic

Prefer ceftriaxone for CNS infection in renal failure