Introduction

Name

• Cefotaxime.

Class of drug

• Third generation cephalosporin antibiotic.

Description

Chemical name

• (6R,7R,Z)-3-(Acetoxymethyl)-7-(2-(2-aminothiazol-4-yl)-2-(methoxyimino)acetamido)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid.

Molecular formula

• C₁₆H₁₇N5O₇S₂.

Molecular weight

• 455.47 g/mol. 

Physical properties

• Odorless, white to off-white crystalline powder.

Storage requirements

• Sterile powder for injection should be stored at temperatures of <30°C/86°F and protected from light.
• Darkening may indicate loss of potency.
• Discard any unused reconstituted solution after 24 h.

Uses

Indications

• Shows good bactericidal activity against many Gram-positive and gram-negative aerobic bacteria. It is ineffective against enterococci and Pseudomonas, as well as methicillin resistant staphylococci Methicillin resistant staphylococcus aureus and extended spectrum ß-lactamase (ESBL) producing Gram negatives.
• Due to expense of the drug and the need for frequent dosing when used systemically, use is typically limited to valuable septic foals and local treatment of infectious arthritis Joint: septic arthritis - foal.

Administration

Pharmacokinetics

Precautions

Interactions

with other drugs

• There is in vitro evidence of synergy between cefotaxime and aminoglycoside antibiotics, eg gentamicin against some species of gram-negative bacteria including some strains of Serratia marcescens, E. coli, Pseudomonas aeruginosa, Klebsiella spp, P. mirabilis and Staphylococcus aureus.
• The bactericidal activity of cephalosporins may be antagonized by the concomitant use of bacteriostatic agents, eg erythromycin Erythromycin, tetracycline Therapeutics: tetracyclines.
• Probenecid interferes with the renal tubular transfer of cephalosporins, delaying their excretion and thereby increasing their plasma concentration.

Adverse Reactions

Further Reading

Publications

Refereed Papers

• Recent references from PubMed and VetMedResource.
• Hordijk J, Farmakioti E, Smit L A M et al (2020) Fecal carriage of extended-spectrum-beta-lactamase/ampC-producing Escherichia coli in horses. Appl Environ Microbiol 86, e02590-19 PubMed.
• Hewson J, Johnson R Arroyo L G et al (2013) Comparison of continuous infusion with intermittent bolus administration of cefotaxime on blood and cavity fluid drug concentrations in neonatal foals. J Vet Pharmacol Ther 36, 68-77 PubMed.
• Orsini J A, Moate P J, Engiles J et al (2004) Cefotaxime kinetics in plasma and synovial fluid following intravenous administration in horses. J Vet Pharmacol Ther 27, 293-298 PubMed.

Other sources of information

• Plumb D C (2018) Plumb’s Veterinary Drug Handbook. Wiley Blackwell, USA. Website: https://app.plumbs.com.
• Cole C, Bentz B & Maxwell L (2014) Equine Pharmacology. Wiley Blackwell, USA.
• Giguère S, Prescott J F & Dowling P (2013) Eds Antimicrobial Therapy in Veterinary Medicine. 5th edn. Wiley Blackwell, USA.

Organisation(s)

• National Office of Animal Health (NOAH) Compendium of Data Sheets for Animal Medicines. Website: www.noahcompendium.co.uk.