Cefotaxime
Claforan
3rd-generation cephalosporin
β-lactam cell-wall inhibitor. Broad gram-negative + CNS penetration.
Indications
- •Meningitis, sepsis, pneumonia
- •Spontaneous bacterial peritonitis
Dosing
| Context | Adult | Pediatric |
|---|---|---|
| Serious infection | 1–2 g IV q6–8h | — |
Pharmacokinetics
Half-life ~1 h. Hepatic + renal; good CSF penetration.
Side effects
- !Allergy
- !C. difficile
- !No calcium interaction (unlike ceftriaxone — safe in neonates)
Contraindications
- ×Severe cephalosporin allergy
Clinical pearls
- ★Preferred over ceftriaxone in NEONATES (no calcium-precipitation/biliary-sludge risk).
- ★Good CSF penetration → meningitis coverage.
Other drugs in Antibiotics
- Cefazolin
β-lactam — inhibits bacterial cell wall PBPs.
- Vancomycin
Inhibits cell wall synthesis (binds D-Ala-D-Ala). Active against MRSA + gram-positives.
- Clindamycin
Binds 50S ribosomal subunit, blocks peptide-bond formation. Bacteriostatic against most organisms; bactericidal against susceptible streptococci. Excellent activity against anaerobes and gram-positive cocci including community-acquired MRSA.
- Gentamicin
Binds 30S ribosomal subunit, causes misreading of mRNA → defective bacterial protein synthesis. Bactericidal, concentration-dependent killing. Synergy with cell-wall agents (β-lactams, vancomycin) for gram-positive endocarditis.
- Cefuroxime
β-lactam — inhibits cell-wall synthesis (PBP binding). 2nd-gen: gram-positive + expanded gram-negative.
- Cefepime
β-lactam cell-wall inhibitor. Broad gram-negative (incl. Pseudomonas) + gram-positive coverage.
- Cefotetan
β-lactam; adds anaerobic (B. fragilis) coverage → colorectal/gynecologic prophylaxis.
Suggested reading
- •Miller's Anesthesia, 9e
- •FDA package insert