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Why it's used

Cefotaxime is used to treat reproductive organs, kidney, and urinary system infections, lower respiratory tract infections, blood, skin, bone and joint infections, intra-abdominal infections, and central nervous system infections. It can also be used for tick-borne illness. It can be used with other antibacterial drugs for the treatment of infection in the brain and heart valves. It is a prescription medicine. This medicine works by blocking the synthesis of the bacterial cell wall. Cefotaxime is also used to prevent infections in patients having certain surgeries such as removal of uterus and surgery of stomach, intestine, reproductive organs and urinary system. Cefotaxime should be given before, during, or after cesarean delivery to prevent infections.
Cefotaxime may also be taken in combination with other medicines to treat certain conditions as recommended by the doctor. Cefotaxime is used together with Aminoglycoside Antibacterial to treat severe, life-threatening infections without susceptibility of a specific microorganism and also treat infections with Pseudomonas aeruginosa. Cefotaxime is also used with Antibacterial to prevent infection in patients with a weakened immune system.
When not to use
Cefotaxime cannot be used to treat viral infections such as common cold. Cefotaxime will not work against bacterial infection caused by Chlamydia trachomatis.
Cephalosporin Antibacterials
Cefotaxime belongs to a class of medicines called Cephalosporin Antibacterials. Cephalosporin antibacterials are an antibiotic class of medicines which are used to treat bacterial infections such as kidney and urinary tract infections, respiratory tract infections, and skin infections.

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How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Cefotaxime. If you have any questions related to this medicine, ask your doctor or pharmacist. Inject this medicine as recommended by your doctor.

Typical Dosage

The typical dose of Cefotaxime is 500-12000 mg daily in divided doses based on the severity of infection (not more than 12000 mg/day). The usual dose for children is 50-180 mg/kg (22.7-81.8 mg/lb) in divided doses based on the patient's age and body weight. The maximum adult dose of Cefotaxime is 12000 mg in a day. This medicine is not known to be habit-forming.
You should continue to use this medicine as directed by the doctor even if you feel well.
The injection form of the medicine may be used on the vein, or large muscle such as the upper part of the buttock. Cefotaxime should be injected in different muscle sites of the body. Injection into the vein and infusion should be given over a period of 3-5 minutes and over 50-60 minutes respectively. 500 mg and 1000 mg of Cefotaxime should be dissolved in 2 ml and 4 ml of sterile water for injection into vein and muscle respectively. For infusion, 2000 mg of Cefotaxime should be dissolved in 100 ml of isotonic glucose solution or sodium chloride. Add lidocaine solution in injection into the muscle to avoid pain on the site of injection.

Talk to Your Doctor

Talk to your doctor if you develop new symptoms. Tell your doctor if watery and bloody stool, stomach cramps, and fever. If you have any kidney disease, the dose of Cefotaxime should be decreased to half of the normal dose in patients with creatinine clearance less than or equal to 20 ml/minute. 1000 mg dose of Cefotaxime divided into 2 doses should be given in every 12 hours in patients with creatinine clearance less than or equal to 5 ml/minute.

Use in Children

If you are giving Cefotaxime to a child, be sure to use a product that is meant for children. Before giving this medicine to a child, use the child's weight or age to find the right dose from the product package. If the product package does not provide specific information as to how the medicine can be given to children, consult with your doctor and follow their recommendation.

Lab Tests

Your doctor may request that specific lab tests be performed before you start using Cefotaxime. You may need to have Antibiotic Susceptibility test. Antibiotic susceptibility test is required to help in selecting an appropriate antibacterial drug for the treatment.

Storage

You should store Cefotaxime in a freezer at -20°C (-4°F) and Cefotaxime in dry form should be stored below 30°C (86°F), and away from light. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Cefotaxime for conditions for which it was not prescribed. Do not give Cefotaxime to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Cefotaxime

Your dose and how often you take Cefotaxime will depend on the following factors:
  • age
  • gender
  • weight
  • patient's health
  • the health of the patient's liver

Cefotaxime Dosage

Dosage for inflammation of urethra/cervix

Adult
  • Recommended: 500 mg injection into the muscle in a single dose

Dosage for rectal bacterial infection (rectal gonorrhea)

Adult
  • Recommended: 500 mg injection (for females) and 1000 mg injection (for males) into the muscle in a single dose

Dosage for uncomplicated infections

Adult
  • Recommended: 1000 mg injection into the muscle or vein every 12 hours (2000 mg daily)

Dosage for moderate to severe infections

Adult
  • Recommended: 1000-2000 mg injection into the muscle or vein every 8 hours (3000-6000 mg daily)

Dosage for blood infection

Adult
  • Recommended: 2000 mg injection into the vein every 6-8 hours (6000-8000 mg daily)

Dosage for life-threatening bacterial infections

Adult
  • Recommended: 2000 mg injection into the vein every 4 hours (up to 12000 mg daily)

Dosage for prevention of infection after surgery

Adult
  • Recommended: 1000 mg injection into muscle or vein 30-90 minutes before the surgery

Dosage for prevention of infection during caesarean delivery

Adult
  • Recommended: 1000 mg injection into the vein after clamped umbilical cord and after the first dose, 1000 mg injection into muscle or vein at 6-12 hours should be given.

Dosage for lyme disease

Adult
  • Recommended: 2000 mg three times daily for 14-21 days (not more than 6000 mg/day)

Forms

Injection
Strength: 500 mg, 1000 mg, 2000 mg, 10000 mg, 1000 mg/50 ml, and 2000 mg/50 ml
Injection, Powder, for Solution
Strength: 250 mg, 500 mg, 1000 mg, 2000 mg, 10000 mg, and 1000 mg/1 ml

Special Instructions

Newborns
50 mg/kg (22.7 mg/lb) dose into the vein should be given every 12 hours in the newborn child aged from birth to 1 week and every 8 hours in the newborn child aged 1-4 weeks.
Children aged 1 month to 12 years
50-180 mg/kg (22.7-81.8 mg/lb) dose into muscle or vein should be given in children weighing less than 50 kg (110 lb) in 4-6 divided doses. Children weighing more than 50 kg (110 lb) should use the same dose as adults.
Older patients
Older patients are more susceptible to kidney dysfunction. So, care should be taken while selecting the dose and provide close monitoring of the functioning of the kidney in such patients.
Creatinine clearance
The dose of Cefotaxime should be decreased to half of the normal dose in patients with creatinine clearance less than or equal to 20 ml/minute. 1000 mg dose of Cefotaxime divided into 2 doses should be given in every 12 hours in patients with creatinine clearance less than or equal to 5 ml/minute.

Missed Dose

If you have skipped the injection, talk to your doctor.

Overdose

What to do if you overdose on Cefotaxime?
In case of overdose, close supervision and supportive care should be provided. Symptomatic treatment should be started for side effects such as seizures and severe allergic reactions. Also, provide treatment of cramps with phenobarbital or diazepam, not with phenytoin. Cefotaxime should be removed from the body by blood purifying technique (called hemodialysis or peritoneal dialysis).
Symptoms of an overdose of Cefotaxime
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • cramp
  • elevation of blood urea nitrogen
  • elevations of creatinine
  • increased central nervous system activity
  • reversible altered mental state
  • seizure
If you think you have overdosed on Cefotaxime, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Cefotaxime

Before you use Cefotaxime, tell your doctor of your medical and health history including the following:
  • allergies
  • asthma
  • colitis
  • gastrointestinal diseases
  • having any blood or urine tests
  • heart disorder
  • kidney disorder
  • low sodium diet
In such patients, Cefotaxime should be used with caution.
Before you use Cefotaxime, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Discuss with your doctor if you are allergic to cefotaxime sodium, cephalosporin antibiotics, lidocaine, other local amide-type anesthetics, or penicillin.
The use of Cefotaxime may change Blood urea nitrogen level. This medicine may temporarily increase the level of urea and nitrogen in the blood.
The use of this medicine may change Liver enzyme levels. This medicine may temporarily increase the level of liver enzymes (aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and alkaline phosphatase).
The use of Cefotaxime may change Blood counts. The treatment with this medicine may result in an abnormal level of blood cells count and bone marrow suppression. If the patients are using this medicine for longer than 10 days, than it is advised to monitor blood cell levels and discontinue the treatment in case of abnormal results.

Use when Pregnant

Cefotaxime should be used only when required in patients who are pregnant or planning to become pregnant. This medicine should only be used in pregnancy if the possible benefits outweigh the potential risk.

If Breastfeeding

Consult with your doctor on the use of Cefotaxime during breastfeeding. This medicine may pass into breast milk in low amount. It may affect the gut bacteria (physiological intestinal flora) with diarrhea, colonization by fungi and may also lead to sensitization of the newborn baby. A decision should be made whether to discontinue the therapy or breastfeeding according to the possible benefits of the treatment to the mother and the benefits of breastfeeding to the baby.

If trying to Conceive

Consult with your doctor on the use of Cefotaxime, if you are trying to conceive.

Seizures

Cefotaxime can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Cefotaxime can worsen the sleepiness. Cefotaxime may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.

Side-effects in Older Patients

Older patients may have a higher incidence of side-effects when using Cefotaxime.

Long-term Use

The long term use of this medicine may lead to overgrowth of drug-resistant organisms and abnormal level of blood cells.

What precautions should be taken during Pregnancy and Nursing, and administering Cefotaxime to Children or the Older Adults?

Pregnant Women

Only When Necessary
Warning: This medicine should only be used in pregnancy if the possible benefits outweigh the potential risk.

Breastfeeding

Only When Necessary
Warning: This medicine may pass into breast milk in low amount. It may affect the gut bacteria (physiological intestinal flora) with diarrhea, colonization by fungi and may also lead to sensitization of the newborn baby. A decision should be made whether to discontinue the therapy or breastfeeding according to the possible benefits of the treatment to the mother and the benefits of breastfeeding to the baby.

Younger Adults Population

Possibly safe
Warning: 

Older Adults Population

Precaution
Warning: There are no well-controlled studies regarding the safety and effectiveness of this medicine for older adults. But this drug is known to be excreted by the kidneys: that's why the risk of toxic reactions increases in patients with kidney dysfunction. Elderly patients are more likely to have kidney problems, so it is advised to monitor the functioning of the kidneys, and dose should be selected carefully in these patients.

Cefotaxime Side-effects

The following side-effects may commonly occur when using Cefotaxime. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Cefotaxime may cause the following side-effects:
  • abnormal movements
  • blood reactions to lidocaine
  • bruising
  • change in urine output
  • cloudy, bloody and dark urine
  • dizziness
  • false-positive test for urinary glucose
  • fungal infection (moniliasis)
  • headache
  • hives
  • joint discomfort
  • painful joints
  • redness and swelling at the injection site
  • stomach pain
  • swelling of eyelids, face, lips or throat
  • temporary elevation in liver enzymes
  • temporary elevation of blood urea nitrogen (BUN)
  • temporary elevation of waste products in the blood (creatinine)
The following severe side-effects may also occur when using Cefotaxime:
  • Liver disorders
    Symptoms: inflammation of the liver (hepatitis), jaundice, reduction or stoppage of bile flow (cholestasis) elevations of liver enzyme (gamma GT) and bilirubin
    If this happens, ask your doctor.
  • Stomach or intestinal disorder
    Symptoms: diarrhea, vomiting inflammation of the colon (pseudomembranous colitis)
    Ask your doctor if you experience any of these symptoms.
  • Heart disorders
    Symptoms: irregular heart rhythm
    Talk to your doctor if you get this side effect.
  • Nervous system disorders
    Symptoms: altered brain function (encephalopathy), disturbed consciousness seizures
    Ask your doctor if you experience any of these symptoms.
  • Symptoms: decrease in white blood cells count (leukopenia), increase in the number of blood platelets, abnormally low count of white blood cells (neutropenia), positive direct Coombs tests, anemia due to the breakdown of red blood cells (hemolytic anemia), reduced number of white or red blood cells and platalets (pancytopenia) bone marrow failure
    If this happens, ask your doctor.
  • Kidney disorders
    Symptoms: swelling in between the tubules of the kidney (interstitial nephritis), acute kidney failure decrease in the functioning of the kidney
    Ask your doctor if you experience any of these symptoms.
  • Skin disorders
    Symptoms: rash, severe skin reactions (erythema multiforme and Stevens-Johnson syndrome) drug-induced severe skin reaction
    If this happens, call your doctor immediately.
  • Immune system disorders
    Symptoms: a severe allergic reaction (anaphylactic reactions), swelling due to fluid accumulation, tightening of muscles in the lungs (bronchospasm) life-threatening allergic reaction (anaphylactic shock)
  • Genitourinary system disorders
    Symptoms: vaginal infection (vaginitis)
  • General disorders
    Symptoms: fever
    Ask your doctor if you experience this symptom.
Your doctor has prescribed this Cefotaxime because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Cefotaxime.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Cefotaxime by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:
  • abnormal movements
  • blood reactions to lidocaine
  • bruising
  • change in urine output
  • cloudy, bloody and dark urine
  • dizziness
  • false-positive test for urinary glucose
  • headache
  • hives
  • joint discomfort
  • moniliasis
  • painful joints
  • redness and swelling at the injection site
  • stomach pain
  • swelling of eyelids, face, lips or throat
  • temporary elevation in alanine aminotransferase (ALT)
  • temporary elevation in aspartate aminotransferase (AST)
  • temporary elevation in serum lactate dehydrogenase (LDH), and serum alkaline phosphatase levels
  • temporary elevation of blood urea nitrogen (BUN)
  • temporary elevation of waste products in the blood (creatinine)

Severe Side-effects

Following are the severe side-effects of this medicine:

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:
  • abnormal movements
  • hives
  • severe skin rash with itching
  • swelling of eyelids, face, lips or throat

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
  • convulsions
  • drug induced severe skin reaction (toxic epidermal necrolysis, acute generalized exanthematous pustulosis)
  • life-threatening allergic reaction (anaphylactic shock)
  • loss of consciousness
  • serious illness with blistering of the skin, mouth, eyes, and genitals
  • severe allergic reaction (anaphylactic reactions)
  • severe skin reactions (erythema multiforme and Stevens-Johnson syndrome)
  • sudden wheeziness
  • swelling due to fluid accumulation (angioedema)
  • tightness of chest
If this happens, call your doctor immediately.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Sodium Restriction

Patients with sodium restriction are at an increased risk when using Cefotaxime. The amount of sodium in Cefotaxime should be taken into account when using in patients with sodium restriction.

Laboratory Tests

Patients using Cefotaxime are at an increased risk. These patients may develop a positive Coombs test due to which the risk of cross-matching of blood increases. Such patients may also develop a false positive urine glucose testing.

Kidney Dysfunction

Elderly patients and patients with existing kidney dysfunction are at an increased risk when using this medicine. Patients with kidney insufficiency may suffer from brain disease (encephalopathy) by using high doses of this medicine and other beta-lactam antibiotics. The dose of Cefotaxime should be adjusted according to the creatinine clearance. Caution should be used when Cefotaxime is given together with aminoglycosides or other drugs that cause kidney damage. The functioning of the kidneys should be monitored in elder patients and existing kidney dysfunction.

Abnormal Blood Counts

Patients using Cefotaxime are at an increased risk. Treatment with this medicine may result in an abnormal level of blood cells count and bone marrow suppression. If the patients are using this medicine for longer than 10 days, than it is advised to monitor blood cell levels and discontinue the treatment in case of abnormal results.

Serious Skin Reactions

Patients using Cefotaxime are at an increased risk. These patients may suffer from severe skin reactions such as Stevens-Johnson syndrome. If this happens, contact your doctor immediately.

Diarrhea

Patients using Cefotaxime are at an increased risk. C. difficile-associated diarrhea (CDAD) has been observed over 2 months of Cefotaxime use and may vary in severity from moderate diarrhea to life-threatening inflammation of the colon. Treatment with antibacterial drugs produce toxins, which contribute to the growth of hospital-acquired infection associated with fever. Hypertoxin-producing strains of C. difficile cause increased fatality and disease rate. Patients with such condition may require the removal of the colon. If CDAD is confirmed or not, the use of Cefotaxime against C. difficile needs to be discontinued. Suitable fluid and electrolyte use, protein supplementation, antibacterial therapy of C. difficile, and operational evaluation should be started as indicated.

Allergy

Patients with known allergic reactions to Cefotaxime, penicillins, cephalosporins, or other drugs are at an increased risk when using this medicine. These patients may suffer from severe allergic reactions. Caution should be advised while using this medicine in such patients. If a severe allergic reaction occurs, treatment with this medicine must be stopped. Cefotaxime should not be used in patients with a history of immediate-type severe allergic reactions to cephalosporins.

Interactions with Cefotaxime

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Cefotaxime. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Glucose Test

Your doctor's guidelines may need to be followed while taking this medicine along with glucose test, which used to determine glucose in the blood and urine. False positive or false negative results may occur in glucose determinations in blood and urine while taking Cefotaxime. Copper reduction tests may show false positive results for urine glucose.

Diuretics and Kidney Damaging Drugs

Cefotaxime interacts with diuretics, which are used to treat high blood pressure. The use of Cefotaxime with diuretics (furosemide) and kidney damaging drugs (aminoglycoside antibiotics, colistin, and polymyxin B) may prominent to kidney damage. The functioning of the kidneys should be monitored in such patients.

Antibiotics

There may be an interaction of Cefotaxime with antibiotics (tetracycline, erythromycin or sulfonamides), which are used to treat bacterial infections. The use of Cefotaxime with other antibacterial drugs which stop the growth of bacteria may block the effect of Cefotaxime. The combination with aminoglycosides may result in other effects than its use. The use of Cefotaxime with cephalosporins or aminoglycosides may cause kidney and ear problems. Monitor the functioning of the kidney and dose adjustment may be needed for such patients.

Uricosuric Agents

Cefotaxime may interact with probenecid, which is used to treat increased uric acid in blood and gout. The use of Cefotaxime with probenecid may increase the amount of Cefotaxime in the blood and decreased excretion. Avoid the use of Cefotaxime more than 6000 mg/day in patients taking probenecid.

Coombs Test

Special instructions need to be followed while taking this medicine along with coombs test, which is used for antibody screening in the blood. There may be false-positive results occur in the Coombs test while taking Cefotaxime.

Interactions of Cefotaxime by Severity

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Cefotaxime be not used?

Allergy

This medicine should not be used in patients with known allergic reaction to it and penicillins, or other cephalosporins. These patients may have the following symptoms if they use this medicine:
  • severe allergic reaction (anaphylactic reactions)
  • swelling due to fluid accumulation
  • life-threatening allergic reaction (anaphylactic shock)
  • severe skin reactions (erythema multiforme and Stevens-Johnson syndrome)
  • drug induced severe skin reaction
  • sudden wheeziness
  • tightness of chest
  • serious illness with blistering of the skin, mouth, eyes, and genitals
  • loss of consciousness
  • convulsions
  • swelling of eyelids, face, lips or throat
  • hives
  • severe skin rashes with itching

Newborn Baby Aged Below 30 Months

This medicine should not be used in combination with lidocaine injection BP in newborn babies aged below 30 months.

Lidocaine Injection

This medicine should not be injected into the veins in combination with lidocaine injection BP. Also, the patients with a history of allergic reaction to lidocaine and other amide-type local anesthetics, patients having a heart block, and patients having severe heart failure should not use this combination.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Cefotaxime is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Cefotaxime .
Bacterial Infections
Lyme Disease
Skin Infections
Urinary Tract Infections

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