General Information

  • EMPIRIC therapy of severely ill patients with suspected Gram-negative infection
  • Documented Gram-negative infection resistant to 1st and 2nd generation cephalosporins
  • Meningitis, brain abscess
  • Spontaneous bacterial peritonitis, community-acquired secondary peritonitis (or hospital acquired with no previous antimicrobial therapy), or intra-abdominal abscess
  • Salmonella
  • Severe community-acquired pneumonia (DS-CRB65 ≥ 4 or ICU admission)
  • Gonorrhea
  • Pelvic Inflammatory Disease, Epididymitis
  • Some endocarditis infections
  • Synergy in some Enterococci endocarditis infections, particularly if gentamicin is contraindicated
  • Complicated Lyme infections


  • Does not cover Listeria, Pseudomonas, ESBLs or AmpC producing Enterobacteriaceae
  • Avoid in patients with biliary sludging or cholestatic hepatitis (see Cefotaxime)
  • Avoid for serious Citrobacter or Enterobacter infections, even if reported as susceptible
  • Allergy/rash (immediate or delayed)
  • Cytopenias
  • Eosinophilia
  • Hepatic and renal laboratory abnormalities
  • Gallbladder pseudolithiasis - more likely if on TPN and using ≥ 2g/day
  • Drug induced immune thrombocytopenia

Antimicrobial class: Parenteral Cephalosporin - 3rd Generation

Pregnancy category: B

Average serum half life: 8 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Biliary penetration: Therapeutic