Otitis

Cefotaxime analogs in tablets instructions for use. What tablets can replace this antibiotic? Directions for use and doses

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In this article you can find instructions for use medicinal product Cefotaxime. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of Cefotaxime in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Cefotaxime in the presence of existing structural analogues. Use for the treatment of infectious and inflammatory diseases in adults, children, as well as during pregnancy and breastfeeding. Dilution (with water or novocaine) and the effect of the antibiotic.

Cefotaxime- cephalosporin antibiotic of the 3rd generation with a wide spectrum of action. It has a bactericidal effect by inhibiting the synthesis of bacterial cell walls. The mechanism of action is due to acetylation of membrane-bound transpeptidases and disruption cross-linking peptidoglycans, necessary to ensure the strength and rigidity of the cell wall.

Highly active against gram-negative bacteria (resistant to other antibiotics): Escherichia coli ( coli), Citrobacter spp., Proteus mirabilis (Proteus), Providencia spp., Klebsiella spp. (klebsiella), Serratia spp., some strains of Pseudomonas spp., Haemophilus influenzae.

Less active against Streptococcus spp. (including Streptococcus pneumoniae) (streptococcus), Staphylococcus spp. (staphylococcus), Neisseria meningitidis, Neisseria gonorrhoeae, Bacteroides spp.

Resistant to most beta-lactamases.

Pharmacokinetics

Rapidly absorbed from the injection site. Plasma protein binding is 40%. Widely distributed in tissues and body fluids. Reaches therapeutic concentrations in cerebrospinal fluid, especially with meningitis. Penetrates the placental barrier and is excreted breast milk in low concentrations. 40-60% of the dose is excreted unchanged in the urine after 24 hours, 20% in the form of metabolites.

Indications

Infectious and inflammatory diseases caused by sensitive microorganisms, including:

central nervous system infections (meningitis);
infections respiratory tract and ENT organs;
infections urinary tract;
bone and joint infections;
skin and soft tissue infections;
pelvic organ infections;
abdominal infections;
peritonitis;
sepsis;
endocarditis;
gonorrhea;
infected wounds and burns;
salmonellosis;
Lyme disease;
infections due to immunodeficiency;
prevention of infections after surgical operations (including urological, obstetric and gynecological, on the gastrointestinal tract).

Release forms

Powder for the preparation of solution for intravenous and intramuscular injection(injections in ampoules for injection) 250 mg, 500 mg and 1 gram of powder for dilution in water for injection or novocaine.

Instructions for use and dosage

The drug is administered intravenously (stream or drip (in a dropper) and intramuscularly.

For uncomplicated infections, as well as for urinary tract infections - 1 g IM or IV every 8-12 hours.

For uncomplicated acute gonorrhea - intramuscularly in a dose of 1 g once.

For infections moderate severity- IM or IV 1-2 g every 12 hours.

For severe infections, for example, meningitis - IV 2 g every 4-8 hours, maximum daily dose -12 g. The duration of treatment is determined individually.

In order to prevent the development of infections before surgery administered during induction of anesthesia in a single dose of 1 g. If necessary, the administration is repeated after 6-12 hours.

At caesarean section- at the time of applying clamps to the umbilical vein - intravenously at a dose of 1 g, then 6 and 12 hours after the first dose - an additional 1 g.

Premature and newborns under 1 week of age - IV at a dose of 50 mg/kg every 12 hours; at the age of 1-4 weeks - IV at a dose of 50 mg/kg every 8 hours. Children weighing ≤50 kg - IV or IM (children over 2.5 years old) 50-180 mg/kg IV 4-6 injections.

For severe infections (including meningitis) daily dose when prescribed to children, increase to 100-200 mg/kg, IM or IV for 4-6 injections, the maximum daily dose is 12 g.

Rules for preparing injection solutions

For intravenous injection: 1 g of the drug is diluted in 4 ml of sterile water for injection; the drug is administered slowly over 3-5 minutes.

For intravenous infusion: 1-2 g of the drug is diluted in 50-100 ml of solvent. The solvent used is 0.9% sodium chloride solution or 5% dextrose (glucose) solution. Duration of infusion - 50 - 60 minutes.

For intramuscular administration: 1 g is dissolved in 4 ml of solvent. Water for injection or a 1% solution of lidocaine (novocaine) is used as a solvent.

Side effect

headache;
dizziness;
renal dysfunction;
oliguria;
nausea, vomiting;
diarrhea or constipation;
flatulence;
abdominal pain;
dysbacteriosis;
stomatitis;
glossitis;
pseudomembranous enterocolitis;
hemolytic anemia, leukopenia, neutropenia, granulocytopenia, thrombocytopenia, agranulocytosis;
potentially life-threatening arrhythmias following rapid central venous bolus administration;
increased concentration of urea in the blood;
positive Coombs reaction;
phlebitis;
pain along the vein;
pain and infiltration at the site of intramuscular injection;
hives;
chills or fever;
rash;
itchy skin;
bronchospasm;
eosinophilia;
anaphylactic shock;
superinfection (vaginal and oral candidiasis).

Contraindications

pregnancy;
children up to 2.5 years of age (for intramuscular administration), with caution in newborns;
hypersensitivity (including to penicillins, other cephalosporins, carbapenems).

Use during pregnancy and breastfeeding

Use in the 2nd and 3rd trimesters of pregnancy and lactation is possible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus or infant.

It should be kept in mind that after intravenous administration cefotaxime at a dose of 1 g after 2-3 hours maximum concentration active substance in breast milk averages 0.32 mcg/ml. At this concentration it is possible bad influence on the child’s oropharyngeal flora.

Experimental studies on animals did not reveal teratogenic or embryotoxic effects of cefotaxime.

Use in children

Use cefotaxime with caution in newborns.

special instructions

In the first weeks of treatment, pseudomembranous colitis may occur, manifested by severe, prolonged diarrhea. In this case, stop taking the drug and prescribe adequate therapy, including vancomycin or metronidazole.

Patients with a history allergic reactions to penicillins, may have increased sensitivity to cephalosporin antibiotics.

When treating with the drug for more than 10 days, monitoring the picture is necessary. peripheral blood.

During treatment with cefotaxime, it is possible to obtain a false-positive Coombs test and a false-positive urine test for glucose.

During treatment, you should not drink alcohol, since effects similar to those of disulfiram are possible (facial hyperemia, spasms in the abdomen and stomach, nausea, vomiting, headache, decreased blood pressure, tachycardia, shortness of breath).

Drug interactions

Cefotaxime increases the risk of bleeding when combined with antiplatelet agents and nonsteroidal anti-inflammatory drugs.

The risk of kidney damage increases with simultaneous administration aminoglycosides, polymyxin B and loop diuretics.

Drugs that block tubular secretion increase plasma concentrations of cefotaxime and slow down its elimination.

Pharmaceutical interactions

Pharmaceutically incompatible with solutions of other antibiotics in the same syringe or dropper.

Analogues of the drug Cefotaxime

Structural analogues of the active substance:

Intrataxim;
Kefotex;
Clafobrine;
Claforan;
Clafotaxime;
Liforan;
Oritax;
Oritaxim;
Resibelacta;
Spirosine;
Tax-o-bid;
Talcephus;
Tarcefoxime;
Tirotax;
Cetax;
Cephabol;
Cefantral;
Cefosin;
Cefotaxime Lek;
Cefotaxime sodium;
Cefotaxime Sandoz;
Cefotaxime Vial;
Cefotaxime sodium salt.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps and look at the available analogues for the therapeutic effect.

Cefotaxime is antibacterial drug, belonging to the group of third-generation cephalosporins. The medicine has bactericidal mechanism effects on pathogenic microorganisms and a wide spectrum of activity. The release form is parenteral, that is, cefotaxime analogs are not produced in tablets. The antibiotic is administered exclusively intravenously or intramuscularly.

Cefotaxime instructions for use injections

The effectiveness of the drug is determined by the fact that the active substance cefotaxime disrupts the synthesis of mucopeptides in the microbial membrane. The drug is active against gram- and gram+ pathogens resistant to other antibiotics, including strains that produce B-lactamases. The bactericidal effect extends to penicillin-, aminoglycoside- and sulfonamide-resistant bacteria.

The maximum concentration of the antibiotic in the blood plasma is achieved half an hour after intramuscular administration. When administered intravenously, maximum plasma levels are achieved within five minutes. Cefotaxime has good binding to plasma proteins and provides an effective antibacterial concentration for twelve hours. Also, it accumulates well in inflamed tissue and organ structures (heart muscle, bone tissue, gall bladder, skin, subcutaneous fat). Significant therapeutic values are also determined in body fluids; in particular, the antibiotic penetrates into the cerebrospinal, pericardial, pleural, peritoneal and synovial fluids.

Given the ability of the antibiotic to cross the placenta barrier, as well as be excreted in breast milk, Cefotaxime during pregnancy and breastfeeding can be prescribed only when absolutely necessary, when there is no safer alternative. Breast-feeding During the period of therapy it is necessary to stop.

The drug is eliminated from the body through urine. About 20% of the excreted drug is utilized in the form of desacetylcefotaxime (a metabolite of cefotaxime, which also has antibacterial activity). A small part of the drug is excreted in bile, and in lactating women - in breast milk.

Pharmacological group of the drug

The pharmacological group of the drug is antibiotics.

Group of antibiotics: Cefotaxime belongs to the 3rd generation parenteral cephalosporins.

Composition and release form of the drug

The active substance is cefotaxime.

The drug is used only by injection. In tablets, capsules, syrups, etc. Cefotaxime is not available, and there is no suspension for children either!

The solution is sold in bottles with lyophilisate (powder for making injection solution), containing five hundred, 1000 and 2000 milligrams of antibiotic in the form of Na salt. The prepared solution is administered intravenously or intramuscularly.

Cefotaxime Photos

Cefotaxime recipe in Latin

Rp.:Cefotaximi1.0.

D.t.d No. 12 in flac.

Spectrum of antimicrobial activity

Cefotaxime is active against bacteria resistant to aminoglycosides, penicillins, and sulfonamides.

The antibiotic is effective against staphylococci (including strains capable of producing penicillinase), streptococci, diphtheria corynebacteria, enterobacteria, Escherichia coli, acinetobacter, hemolytic bacillus (including strains resistant to ampicillin), Klebsiella, Neisseria (gonococci and meningococci), propionobacteria, protea, serrations, yersinia, bordetella, fusobacteria, bacteroides, moraxella, peptostreptococci, etc.

Compared to the first and second generation cephalosporins, Cefotaxime is less active against gramcocci.

Listeria, group D streptococci, and staphylococci that are resistant to methicillin are resistant to the antibiotic.

Which is better: Cefotaxime or Ceftriaxone?

Both drugs belong to the third generation of cephalosporins and have a similar mechanism of action and spectrum of antimicrobial activity.

Also, both Ceftriaxone and Cefotaxime have only a parenteral release form, that is, they are used exclusively intravenously or intramuscularly.

The main difference between Ceftriaxone and Cefotaxime is that it displaces bilirubin from its connection with albumin, therefore, when prescribing Ceftriaxone to newborns, there is a risk of developing kernicterus. The solution also has a dual elimination route (it is disposed of in urine and bile).

Cefoperazone does not show similar action and can be prescribed to babies from the first days of life (up to 2.5 years it is prescribed only intravenously). Also, it is more effective against MSSA staphylococci.

Indications and contraindications for use

The drug is successfully prescribed for infections varying degrees severity affecting:

ENT organs;
breath paths (upper and lower);
urinary and reproductive system;
organs abdominal cavity(including with the development of peritonitis);
skin and fatty acids;
musculoskeletal system.

Also, the antibiotic is prescribed for severe septicemia, bacteremia, meningitis (with the exception of meningitis caused by Listeria) and other infections of the central nervous system. nervous system.

Cefotaxime can be used in the treatment of:

complicated and uncomplicated forms of gonorrhea;
chlamydia;
Lyme disease;
endocarditis;
salmonellosis;
purulent-inflammatory diseases against the background of immunodeficiency states;
severe gynecological infections (including septic abortions).

In surgery it is used for prophylactic purposes, to prevent the development of septic complications.

The medicine is contraindicated in persons with individual intolerance to B-lactam drugs, with bleeding, if the patient has nonspecific ulcerative colitis, severe heart failure, or AV block.

Despite the fact that cephalosporins are on the list of antibiotics approved for use during pregnancy, cefotaxime should only be used when absolutely necessary, in the absence of a safer alternative.

Cefotaxime is not prescribed during breastfeeding. If it is necessary to use it in lactating women, breastfeeding is stopped for the entire period of treatment.

Age restrictions must also be taken into account. The medicine can be administered intravenously from the first days of life, however intramuscular use allowed only from 2.5 years.

Can be used with caution to treat patients with chronic renal failure (chronic renal failure).

When administered intramuscularly, additional contraindication is an allergy to lidocaine.

Dosage of Cefotaxime injections

Used for intravenous and intramuscular administration. Intravenously, Cefotaxime can be administered either as a stream or as a drip. Before use, a skin test for sensitivity to the antibiotic must be performed. If the drug is administered intramuscularly, an additional test for lidocaine is performed.

Cefotaxime can be used intravenously from the first days of life. Intramuscular administration is allowed for children over 2.5 years old.

For adult patients and children weighing more than 50 kilograms, an antibiotic is prescribed in standard dose-1000 mg twice daily. The prescribed dosages are adjusted according to the severity of the patient's condition. If necessary, the drug can be administered up to 6 times a day. The maximum daily dose is twelve grams.

Patients with an uncomplicated form of gonorrhea are administered 1000 mg once, intramuscularly. For women, repeated administration is recommended after twelve hours.

For infectious and inflammatory processes localized in the urinary tract, it is necessary to prescribe 1000 mg 2-3 times a day.

For the treatment of infectious diseases with moderate course it is necessary to administer 1-2 grams of the drug twice a day.

Cefotaxime for bronchitis in children weighing more than fifty kilograms is prescribed one thousand mg twice a day.

For severe infections (for example, meningitis), the dosage of Cefotaxime is 2 grams, every four to eight hours. Exceeding the daily dose of 12 grams is prohibited.

The duration of treatment with Cefotaxime depends on the severity of the disease; the minimum duration of drug therapy is seven days (with the exception of uncomplicated gonorrhea).

If an antibiotic is used before surgery, for prophylactic purposes to prevent purulent-septic complications, then it is administered in a dose of 1000 mg when the patient is put under anesthesia. If necessary, repeated administration is carried out after six to twelve hours.

For women who are indicated for delivery by cesarean section, 1000 mg of the drug is administered intravenously at the moment when a clamp is applied to the umbilical vein. Re-introduction 1 gram of the drug - after six to twelve hours.

Cefotaxime for angina is prescribed in a course lasting from a week to 10 days.

For children weighing less than fifty kilograms, the daily dose is calculated by weight. The standard dose is from 50 to one hundred milligrams per kilogram. The resulting daily dose is divided into three to four administrations.

For meningitis and other severe infections, the daily dose can be increased. In this case, the child is prescribed from 100 to 200 milligrams per kilogram. The resulting dosage is administered four to six times.

Dose of Cefotaxime for newborns and premature infants

Cefotaxime 50 mg/kg/day for a child, divided into two doses, is prescribed until the 1st week of life. The drug is also prescribed to premature babies.

From one week to a full month of life, use from fifty to one hundred mg/kg per day, divided into three administrations.

Dose for patients with renal failure

Taking into account the fact that the drug is eliminated from the body in the urine, for persons with severe renal dysfunction, the dosage is reduced in accordance with creatinine clearance.

If clearance is less than 20 milliliters per minute, it is necessary to reduce the daily dose by half.

How to dilute an antibiotic?

If Cefotaxime is prescribed intravenously as a bolus, then one gram of lyophilisate must be diluted in eight milliliters of 0.9 sodium chloride or solution for injection. The resulting solution must be homogeneous and free of suspended matter and foreign inclusions. The medication must be administered slowly, over three to five minutes.

If the drug is prescribed by drip, then one gram of lyophilisate is diluted with fifty milliliters of saline (preferred) or five percent glucose. The duration of the infusion is about an hour.

When prescribing Cefotaxime for intramuscular injections, the instructions recommend dissolving 1 gram of lyophilisate with four milliliters of water for injection, or four milliliters of a 1% lidocaine solution. The resulting solution is injected deep into the gluteal muscle (upper outer quadrant).

You can also dilute 1 gram of powder with two milliliters of solution for injection and add 2 ml of lidocaine (1%).

How to dilute Cefotaxime with novocaine?

The use of lidocaide as an anesthetic is more preferable. It is almost four times more powerful than novocaine and lasts longer. In addition, novocaine is prohibited for use in children under 12 years of age.

Instructions for use of Cefotaxime also contain information that intramuscular injections are made with lidocaine or injection solution.

As a rule, novocaine is prescribed to adults and patients over twelve years of age who have contraindications to the use of lidocaine.

In this case, use 4 milliliters of 0.5% novocaine solution per 1 gram of antibiotic. The resulting solution is also injected into the upper outer quadrant of the gluteal muscle.

It is important to remember that administering an antibiotic diluted with lidocaine or novocaine into a vein is strictly prohibited!

Side effects of Cefotaxime

The most common complications are gastrointestinal disorders and allergies. Other violations are rare.

Undesirable effects from antibiotic treatment can be manifested by disruption of the gastrointestinal tract (dyspeptic disorders, flatulence, abdominal pain, intestinal dysbiosis, stomatitis and glossitis rarely occur).

When treated with Cefotaxime, there is a risk of pseudomembranous colitis. It's hard and dangerous complication, which is accompanied by prolonged diarrhea (up to 20 times a day). It is associated with the activation of Clostridium difficile in the intestine, so treatment includes the immediate discontinuation of cephalosporin and the appointment of Vancomycin or Metronidazole (the drugs are administered orally).

Women may develop thrush after treatment.

Allergic reactions may be varying degrees severity from urticaria or skin itching to angioedema, toxic epidermal necrolysis, anaphylactic reactions etc.

The hepatobiliary system can react with hepatitis, acute liver failure, stagnation of bile, jaundice, etc.

There may also be changes in blood tests. A decrease in the number of neutrophils, leukocytes, agranulocytes, and an increase in the number of eosinophils may be observed. IN biochemical analysis Hepatic transaminases may increase.

Hemolytic anemia and hypocoagulation develop extremely rarely.

Sometimes patients complain of headaches, increased fatigue and drowsiness. In isolated cases, convulsions and reversible encephalopathy are possible.

At the injection site, pain, redness, tissue infiltration (with intramuscular injection) or phlebitis (with intravenous injection) are possible.

Cefotaxime during pregnancy

That is, the drug can be prescribed to pregnant women if necessary, in cases where there is no safer alternative.

In a study in pregnant rats, the antibiotic was not found to be teratogenic or mutagenic, but there are no reliable data from controlled studies in humans.

In this regard, antibiotics can be prescribed to pregnant women, after a very careful balance of risk and benefit.

Cefotaxime and alcohol - compatibility

The cephalosporin group of antibiotics is not compatible with alcohol. This combination can lead to the development of disulfiram-like reactions. They can manifest as uncontrollable vomiting, tachycardia, rhythm disturbances, feelings of fear, mental disorders, tinnitus, and sudden falls. blood pressure(to the point of collapse). In severe cases it is possible death, due to toxic damage liver and nervous system.

Cefotaxime analogues

The product can be produced under the trade names:

Claforan;
Clafotaxime;
Cefotaxime produced by Biokhimik Saransk;
Razibelakta;
Cephabol;
Cefotaxime, Lecco;
Liforan;
Intrataxim;
Duatax;
Cefotaxime, Biosynthesis;
Taksim;
Cephajet.

Cefotaxime - reviews from doctors

The antibiotic has high efficiency against a wide range of pathogens, can be prescribed from the first days of life and has wide range dosages, allowing them to be effectively adjusted according to the severity of the disease.

In their reviews, many patients speak positively about the drug, noting quick effect from the use of Cefotaxime.

Negative reviews about the drug are associated with painful injections (with intramuscular injection) and complaints of disturbances in the gastrointestinal tract during the use of Cefotaxime. Patients complain of bloating, flatulence, nausea, loss of appetite, etc. Allergic reactions, thrush after a course of treatment, as well as weakness and dizziness during the period of use of the drug are also possible. Other adverse reactions occur extremely rarely.

It is important to understand that Cefotaxime is a powerful and effective antibiotic that should only be used as prescribed by a doctor. Self-medication is unacceptable and can cause irreparable harm to health.

Article prepared
Infectious disease doctor A. L. Chernenko

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Each bottle contains 0.5, 1.0 or 2 g Cefotaxime(according to the INN Cefotaxime)

Release form

The drug is available only in powder form, intended for the preparation of a solution administered intramuscularly or intravenously. The powder may be white or yellowish in color. Glass bottles with a volume of 10 ml are produced in cardboard packs with attached instructions from the manufacturer. Cefotaxime is not available in tablets.

pharmachologic effect

Semi-synthetic antibiotic. The active component belongs to the third generation cephalosporins, used parenterally. The drug is active against gram-negative and gram-positive flora, resistant to the action of sulfonamides, aminoglycosides and Penicillin. The mechanism of antimicrobial action is based on suppression of transpeptidase activity by blocking peptidoglycan.

Pharmacodynamics and pharmacokinetics

After intramuscular injection the maximum concentration is recorded after 30 minutes. 25-40% of the active substance binds to plasma proteins. The bactericidal effect lasts 12 hours. IN gallbladder, bone tissue, myocardium, soft tissues effective concentration is created active substance.

The active component penetrates the placenta and is detected in peritoneal, pleural, synovial, pericardial and cerebrospinal fluids. Almost 90% of the drug is excreted in the urine (20-30% are active metabolites, 60-70% are the original form). With intramuscular administration, the half-life is 1-1.5 hours, with intravenous infusion - 1 hour. No cumulation is observed. Partially active substance is excreted from bile.

The medication is prescribed for infectious diseases .
Indications for use of Cefotaxime for pathology of the respiratory system:

pleurisy;
pneumonia;
bronchitis;
abscesses.

The drug is actively used for:

endocarditis;
septicemia;
bacterial meningitis;
postoperative complications;
Lyme disease;
infections of soft tissues and bones.

The antibiotic Cefotaxime is prescribed for diseases of the throat, nose, ear, kidneys, and urinary tract.

Contraindications

Cefotaxime injections are not prescribed for:

bleeding;
individual hypersensitivity;
carrying a pregnancy;
history of enterocolitis.

For pathologies of the hepatic system and kidneys, it is recommended additional examination from specialists with obtaining a conclusion about the absence of contraindications to antibacterial therapy cephalosporins.

Side effects

Local reactions:

pain during intramuscular injection;
phlebitis with intravenous infusion.

Side effects from the digestive tract:

pseudomembranous colitis;
nausea;
cholestatic jaundice;
increased ALT, AST;
hepatitis;
diarrhea syndrome;
vomit.

Hematopoietic system:

hypoprothrombinemia;
hemolytic anemia;
decrease in number platelets;
neutropenia.

Possible allergic responses (Quincke's edema, increased number of eosinophils, itchy skin), candidiasis, interstitial nephritis . When registering others negative reactions requires the help of a doctor and independent withdrawal of the drug.

Instructions for use (Method and dosage)

Instructions for use of Cefotaxime in adults: every 4-12 hours, administer 1-2 grams intramuscularly or intravenously. IN pediatric practice Cefotaxime injections are also prescribed. Instructions for use for children weighing less than 50 kg: 50-180 mg/kg is administered 2-6 times a day. How many days to inject the antibiotic is determined by the attending doctor, taking into account the underlying disease, general reaction organism, concomitant pathology. Tablets are not available.

How to dilute Cefotaxime for intravenous injection: dilute 1 g of powder in 4 ml of sterile water, inject slowly over 3-5 minutes.

How to dilute Cefotaxime with Novocaine: dilute 1 g of powder in 4 ml of novocaine, administer slowly.

How to dilute the powder? The solvent can be sterile water, Lidocaine and Novocaine. The last two substances are used for pain relief, because. Cefotaxime injections are quite painful.

Overdose

Large dosages over a short period of time can cause encephalopathy, dysbacteriosis and allergic responses. Timely treatment must necessarily include desensitizing medications.

Interaction

Nephrotoxicity increases with treatment with loop diuretics and aminoglycosides. NSAIDs and antiplatelet drugs increase the risk of bleeding. It is unacceptable to mix Cefotaxime with other medications in one syringe (exception Novocaine, Lidocaine). Probenecid increases the concentration of the active substance, slows down its excretion.

Terms of sale

The antibiotic is sold in pharmacies. Presentation of a doctor's prescription form is required. Recipe in Latin:
Rp. Sol. Cefotaximi 1.0 g(dose in grams)
D.t.d. N (quantity indicated)
S. i.v. (or i.m.)

Best before date

special instructions

Therapy with nephrotoxic drugs requires mandatory monitoring of the renal system. When treatment lasts more than 10 days, it is necessary to evaluate changes in peripheral blood. Elderly and weakened patients for prevention hypocoagulation appoint vitamin K. When pseudomembranous colitis is diagnosed, treatment is stopped.

Analogues of Cefotaxime Level 4 ATX code matches:

Claforan;
Cefosin;
Cephabol.

Analogs of Cefotaxime in tablets are not available.

Cefotaxime for children

The dosage of Cefotaxime for children is calculated according to the following scheme: 50-180 mg/kg/day. Cefotaxime is prescribed to children with caution. Not prescribed for newborns.

Cefotaxime and alcohol

Alcohol during antimicrobial treatment may cause effects similar to those of Disulfiram:

a fall blood pressure;
facial skin hyperemia;
tachycardia;
migraine headache;
epigastric spasms;
vomit;
dyspnea;
tachycardia.

During pregnancy (and lactation)

Contraindicated in the first trimester. At breastfeeding, in II and III trimesters An antibiotic can only be used in cases where the benefit to the mother outweighs the risk to the fetus. During lactation, the medication can change the oropharyngeal flora of the child. The embryotoxic and teratogenic effects of the drug have not been confirmed in experimental studies on animals. Doctors do not recommend using antibiotics for pregnancy.

In this article you can read the instructions for use of the drug Cefotaxime. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Cefotaxime in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Cefotaxime in the presence of existing structural analogues. Use for the treatment of infectious and inflammatory diseases in adults, children, as well as during pregnancy and lactation. Dilution (with water or novocaine) and the effect of the antibiotic.

Cefotaxime- cephalosporin antibiotic of the 3rd generation with a wide spectrum of action. It has a bactericidal effect by inhibiting the synthesis of bacterial cell walls. The mechanism of action is due to acetylation of membrane-bound transpeptidases and disruption of peptidoglycan cross-linking, which is necessary to ensure the strength and rigidity of the cell wall.

Highly active against gram-negative bacteria (resistant to other antibiotics): Escherichia coli (Escherichia coli), Citrobacter spp., Proteus mirabilis (Proteus), Providencia spp., Klebsiella spp. (klebsiella), Serratia spp., some strains of Pseudomonas spp., Haemophilus influenzae.

Less active against Streptococcus spp. (including Streptococcus pneumoniae) (streptococcus), Staphylococcus spp. (staphylococcus), Neisseria meningitidis, Neisseria gonorrhoeae, Bacteroides spp.

Resistant to most beta-lactamases.

Pharmacokinetics

Rapidly absorbed from the injection site. Plasma protein binding is 40%. Widely distributed in tissues and body fluids. Reaches therapeutic concentrations in the cerebrospinal fluid, especially in meningitis. Penetrates the placental barrier and is excreted in breast milk in low concentrations. 40-60% of the dose is excreted unchanged in the urine after 24 hours, 20% in the form of metabolites.

Indications

Infectious and inflammatory diseases caused by sensitive microorganisms, including:

central nervous system infections (meningitis);
infections of the respiratory tract and ENT organs;
urinary tract infections;
bone and joint infections;
skin and soft tissue infections;
pelvic organ infections;
abdominal infections;
peritonitis;
sepsis;
endocarditis;
gonorrhea;
infected wounds and burns;
salmonellosis;
Lyme disease;
infections due to immunodeficiency;
prevention of infections after surgical operations (including urological, obstetric and gynecological, on the gastrointestinal tract).

Release forms

Powder for the preparation of a solution for intravenous and intramuscular administration (injections in ampoules for injection) 250 mg, 500 mg and 1 gram of powder for dilution in water for injection or novocaine.

Instructions for use and dosage

The drug is administered intravenously (stream or drip (in a dropper) and intramuscularly.

For uncomplicated infections, as well as for urinary tract infections - 1 g IM or IV every 8-12 hours.

For uncomplicated acute gonorrhea - intramuscularly in a dose of 1 g once.

For moderate infections - 1-2 g intramuscularly or intravenously every 12 hours.

For severe infections, for example, meningitis - IV 2 g every 4-8 hours, maximum daily dose -12 g. The duration of treatment is determined individually.

In order to prevent the development of infections before surgery, it is administered during induction of anesthesia in a single dose of 1 g. If necessary, the administration is repeated after 6-12 hours.

For caesarean section - at the moment of applying clamps to the umbilical vein - intravenously at a dose of 1 g, then 6 and 12 hours after the first dose - an additional 1 g.

In case of severe infections (including meningitis), the daily dose when prescribed to children is increased to 100-200 mg/kg, IM or IV for 4-6 injections, the maximum daily dose is 12 g.

Rules for preparing injection solutions

For intravenous injection: 1 g of the drug is diluted in 4 ml of sterile water for injection; the drug is administered slowly over 3-5 minutes.

For intramuscular administration: 1 g is dissolved in 4 ml of solvent. Water for injection or a 1% solution of lidocaine (novocaine) is used as a solvent.

Side effect

headache;
dizziness;
renal dysfunction;
oliguria;
nausea, vomiting;
diarrhea or constipation;
flatulence;
abdominal pain;
dysbacteriosis;
stomatitis;
glossitis;
pseudomembranous enterocolitis;
hemolytic anemia, leukopenia, neutropenia, granulocytopenia, thrombocytopenia, agranulocytosis;
potentially life-threatening arrhythmias following rapid central venous bolus administration;
increased concentration of urea in the blood;
positive Coombs reaction;
phlebitis;
pain along the vein;
pain and infiltration at the site of intramuscular injection;
hives;
chills or fever;
rash;
skin itching;
bronchospasm;
eosinophilia;
anaphylactic shock;
superinfection (vaginal and oral candidiasis).

Contraindications

pregnancy;
children up to 2.5 years of age (for intramuscular administration), with caution in newborns;
hypersensitivity (including to penicillins, other cephalosporins, carbapenems).

Use during pregnancy and breastfeeding

Use in the 2nd and 3rd trimesters of pregnancy and lactation is possible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus or infant.

It should be borne in mind that after intravenous administration of cefotaxime at a dose of 1 g after 2-3 hours, the maximum concentration of the active substance in breast milk averages 0.32 mcg/ml. At such a concentration, a negative effect on the child’s oropharyngeal flora is possible.

Experimental studies on animals did not reveal teratogenic or embryotoxic effects of cefotaxime.

Use in children

Use cefotaxime with caution in newborns.

special instructions

Patients with a history of allergic reactions to penicillins may have increased sensitivity to cephalosporin antibiotics.

When treating with the drug for more than 10 days, monitoring of the peripheral blood picture is necessary.

During treatment with cefotaxime, it is possible to obtain a false-positive Coombs test and a false-positive urine test for glucose.

Drug interactions

Cefotaxime increases the risk of bleeding when combined with antiplatelet agents and nonsteroidal anti-inflammatory drugs.

The risk of kidney damage increases with concomitant use of aminoglycosides, polymyxin B and loop diuretics.

Drugs that block tubular secretion increase plasma concentrations of cefotaxime and slow down its elimination.

Pharmaceutical interactions

Pharmaceutically incompatible with solutions of other antibiotics in the same syringe or dropper.

Analogues of the drug Cefotaxime

Structural analogues of the active substance:

Intrataxim;
Kefotex;
Clafobrine;
Claforan;
Clafotaxime;
Liforan;
Oritax;
Oritaxim;
Resibelacta;
Spirosine;
Tax-o-bid;
Talcephus;
Tarcefoxime;
Tirotax;
Cetax;
Cephabol;
Cefantral;
Cefosin;
Cefotaxime Lek;
Cefotaxime sodium;
Cefotaxime Sandoz;
Cefotaxime Vial;
Cefotaxime sodium salt.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Composition and release form

Cefotaxime is a white to pale yellow powder, freely soluble in water, practically insoluble in organic solvents. The molecular weight is 447.46 and the half-life is 1.1 hours.

Each vial contains Cefotaxime Sodium 500 mg and 1.0 g;

1 bottle per package.

Pharmacological properties

Cefotaxime is a third generation cefagosporin antibiotic for parenteral use. Acts bactericidal. Possesses wide range antimicrobial action.

Highly active against gram-negative microorganisms resistant to other antibiotics: E.coli, Citobacter, Proteus mirobilis, Proteus indole, Ptovidencia, Klebsiella, Serratia, some strains of Pseudomonas, Haemophlus influenzae. Less active against gram-positive cocci, mainly staphylococci. The drug is highly resistant to betalactamases of gram-negative bacteria. .

Indications

Cefotaxime is used for infections caused by microorganisms sensitive to it (mainly gram-negative); infections of the respiratory and urinary tract, kidneys; infections of the ear, nose and throat, septicemia, endocarditis, meningitis; infections of bones and soft tissues, abdominal cavity; for gynecological infectious diseases, gonorrhea; wound and burn infection and others.

Contraindications

The drug is contraindicated in hypersensitivity to cephalosporin antibiotics.

Possible cross allergy between penicillins and cephalosporins.

Caution is necessary when prescribing the drug to patients with impaired renal and liver function.

In children under 2.5 years of age, intramuscular administration of the drug should not be used.

Directions for use and doses

Cefotaxime is used intramuscularly and intravenously.

For intramuscular injection, dissolve 0.5 g of the drug in 2 ml (respectively 1 g in 4 ml) of sterile water for injection. Injected deep into the gluteal muscle. 1% lidocaine is also used as a solvent for intramuscular administration (0.5 g - 2 ml, 1 g - 4 ml).

For intravenous administration, 0.5 - 1 g of cefotaxime is dissolved in 4 ml (2 g - 10 ml) of sterile water for injection. Inject slowly over 3-5 minutes.

For drip administration (over 50-60 minutes), dissolve 2 g of the drug in 100 ml of isotonic sodium chloride solution or 5% glucose solution.

The usual dose of cefotaxime for adults and children over 12 years of age is 1 g every 12 hours. In severe cases, the dose is increased to 3 or 4 g per day, the drug is administered 3 or 4 times, 1 g each. The maximum daily dose, depending on the severity of the disease, can be increased to 12 g.

Usual Dose for Neonates and Children younger age- 50-100 mg/kg body weight per day with administration intervals from 6 to 12 hours. For premature babies, the daily dose should not exceed 50 mg/kg.

In case of renal dysfunction, the dose is reduced. When creatinine clearance is 10 ml/min or less, the daily dose of the drug is halved.

Cefotaxime is classified as a third generation cephalosporin antibiotic. It acts bactericidal, disrupting the synthesis of the cell wall of microorganisms. Has a wide spectrum of action. Active against gram-positive and gram-negative microorganisms resistant to other antibiotics.

After a single intravenous administration of the drug in doses of 0.5 g, 1.0 g and 2.0 g, the time required to achieve the maximum concentration (Cmax) is 5 minutes, and the maximum concentration is about 39, 101.7 and 214 mcg/ ml respectively.

After intramuscular injection Cefotaxime in doses of 0.5 g and 1.0 g, the maximum concentration is reached after 0.5 hours and is about 11 and 21 μg/ml, respectively. Bonding with plasma proteins is 30-50%. Bioavailability – 90-95%.

The drug is eliminated from the body through urine. About 20% of the excreted drug is utilized in the form of desacetylcefotaxime (a metabolite that also has antibacterial activity). A small part of the drug is excreted with bile, and in nursing women - with breast milk.

Indications for use

What does Cefotaxime help with? The drug is prescribed in the following cases:

infections bronchopulmonary system(bronchitis, pneumonia, pleurisy, lung abscess);

meningitis;
ear, nose and throat infections;
urinary tract infections, kidney infections;
gynecological infections;
infections of the skin, soft tissues, bones and joints, abdominal cavity;
acute uncomplicated gonorrhea.

IN surgical practice the drug is used to reduce the risk of postoperative infections, especially during operations gastrointestinal tract and urological operations.

Instructions for use Cefotaxime, dosage

According to indications, Cefotaxime injections are used for intramuscular or intravenous administration.

Children and adults weighing more than 50 kg are prescribed 1-2 g every 4-12 hours. For body weight less than 50 kg, the dosage is 50-180 mg per kg of body weight per day, divided into 2-6 times.

The maximum dosage for children weighing less than 50 kg is 180 mg per kg of body weight per day, for adults - 12 g per day.

Adults with meningitis or severe meningoencephalitis are prescribed 2 g of the drug 3-4 times a day.

For the purpose of prevention postoperative complications prescribe 1 g of the drug before surgical intervention 1 g of the drug 3 times a day on the first day after surgery.

Side effects

The use of Cefotaxime may be accompanied by the following side effects:

From the nervous system and sensory organs: headache, dizziness.
From the outside of cardio-vascular system and blood (hematopoiesis, hemostasis): cardiac arrhythmias (with rapid jet administration), neutropenia, transient leukopenia, granulocytopenia, eosinophilia, thrombocytopenia, agranulocytosis, hypoprothrombinemia, autoimmune hemolytic anemia.
From the gastrointestinal tract: nausea, vomiting, abdominal pain, diarrhea/constipation, flatulence, dysbacteriosis, transient increase in the activity of liver transaminases, LDH, alkaline phosphatase and bilirubin in the blood plasma; rarely - pseudomembranous colitis, stomatitis, glossitis.
From the outside genitourinary system: increased concentrations of urea nitrogen and creatinine in the blood plasma, interstitial nephritis, impaired renal function, oliguria.
Allergic reactions: rash, hyperemia, urticaria, eosinophilia, multiforme exudative erythema, Stevens-Johnson syndrome, toxic epidermal necrolysis, chills/fever, angioedema, anaphylactic shock.
Other: superinfection, vaginal and oral candidiasis; reactions at the injection site: with an intramuscular injection - pain, hardening and inflammation of tissue at the injection site; with an intravenous injection - phlebitis.

Patients with chronic diseases gastrointestinal organs, especially with colitis, including a history, you should definitely consult a doctor before starting therapy. During injection therapy, the patient's condition should be carefully monitored; if symptoms of colitis occur, it is recommended to immediately stop treatment.

When prescribing the drug simultaneously with loop diuretics and drugs that block tubular secretion, the concentration of Cefotaxime in the blood plasma increases, resulting in an increased risk of developing side effects and overdose. This should be taken into account and the drugs should not be prescribed at the same time.

Contraindications

Cefotaxime is contraindicated in the following cases:

hypersensitivity (including to penicillins, other cephalosporins, carbapenems);
pregnancy first trimester;
intracardiac blockade without an established pacemaker;
severe heart failure;
children up to 2.5 years of age (for intramuscular administration).

Carefully:

neonatal period (for intravenous administration), chronic renal failure, ulcerative colitis(including in medical history).

Overdose

Treatment of overdose consists of immediate cessation of therapy, hemodialysis, and administration of enterosorbents. If necessary, the patient is given symptomatic treatment.

Analogues of Cefotaxime, price in pharmacies

If necessary, you can replace Cefotaxime with an analogue of the active substance - these are the following drugs:

Clafobrin,
Intrataxim,
Kefotex,
Cetax,
Oritax,
Liforan,
Resibelacta,
Cephabol,
Tarcefoxime.

When choosing analogues, it is important to understand that instructions for use of Cefotaxime, price and reviews of drugs similar action do not apply. It is important to consult a doctor and not change the drug yourself.

Price in Moscow pharmacies: Cefotaxime powder for 1 g – 19-33 rubles. Powder for solution 1g No. 5 bottles – from 100 rubles.

Shelf life – 2 years if storage conditions are observed (at temperatures up to 25 degrees Celsius).

The drug Cefotaxime is an antibiotic and is widely used in medical practice.

The drug is effective against large quantity pathogenic microorganisms, for this reason it is often prescribed, even in severe cases of infection.

Cefotaxime is used to treat the urinary tract, so patients need to have information about this drug and its analogues.

Basic information about the drug

As already mentioned, the drug belongs to antibacterial drugs, more precisely 3rd generation cephalosporins. Cefotaxime disrupts the functioning of a protein that is necessary for the construction of the cell wall of the pathogen, thereby causing the death of the latter.

The drug has pronounced effectiveness against those bacteria that are resistant to antibiotics of other groups. It is important to note that Cefotaxime is not subject to destruction under the influence of microbial enzymes.

The drug shows high result in the treatment of pathologies caused by enterococci, streptococci, staphylococci, gonorrheal bacillus, Proteus, clostridia, pseudomonads and other pathogens.

Before prescribing the drug, it is necessary to determine the sensitivity of microbes to the active substance. Only based on the results of this manipulation, treatment tactics are determined.

The active component of the medicine is called cefotaxime. In addition to this, the product contains auxiliary components. The drug is available in the form of powders for injection. A sachet of medicine contains 500 mg and 1 g of active ingredient; the package can contain from 1 to 10 sachets with the drug.

It is important to note that Cefotaxime is only available in the form of a yellowish or white, intended for intramuscular administration. The frequency can be from 1 to 4 times a day, depending on the severity of the pathology. The dose and duration are set and adjusted only by a doctor.

Indications and contraindications for use

Cefotaxime is used to treat infectious pathologies of various organs and systems that are caused by pathogenic microorganisms, sensitive to this drug.

The drug is indicated for the treatment of diseases of the genitourinary tract such as gonorrhea and chlamydia. Cefotaxime is also used to treat infections of the upper and lower respiratory tract, abdominal cavity, musculoskeletal system, central nervous system, cardiac muscle.

Besides, this drug can be used for septicemia and to prevent the development inflammatory process during surgical interventions.

Cefotaxime has contraindications for use. They look like this:

the presence of hyperreactivity reactions in patients to the drug, its analogues or drugs from the same group of antibiotics;
During pregnancy and breastfeeding;
inflammatory processes of the small intestine;
bleeding.

It is worth noting that when prescribing Cefotaxime, caution should be exercised in those people who have impaired renal and liver function.

Similar means

Cefotaxime is produced only in powder form, which is intended for intramuscular administration. The exception is patients childhood(up to 2-3 years), it is better for them to administer the medicine intravenously, but this issue is decided by the attending doctor.

If a drug with an identical mechanism of action, but in a different release form is needed, then specialists switch to Cefotaxime analogues, which also belong to the group of 3rd generation cephalosporins.

As for injection forms, pharmacies have products with identical composition, but produced by other pharmacological companies.

In tablets

Cefotaxime is not produced in tablets. For replacement, drugs with a similar effect are used - for example, cefixime (or Pancef, Solutab). This product is suitable for small children, contains 400 mg of active substance, and is also available in the form of a suspension.

Another analogue is cefuroxime Bioracef, Megasef, Selecef, Cefurox). Tablets are produced in doses of 250 and 500 mg, are convenient and are characterized by high efficiency and good tolerability.

Before prescribing any of the substitutes, it is necessary to test pathogens for sensitivity; without this analysis, any drugs are prohibited, since the situation can only worsen and cause the emergence of resistance in pathogens.

In injections

Available similar drugs for injections, which as active component contain cefotaxime. One of them is from the French company Sanofi. It contains 1 g of cefotaxime. List of other analogues:

Tsefosin (Russia);
Cefantral (India);
(Belarus).

Each of these drugs contains 1 g of active substance, which is administered intramuscularly.

New generation substitutes

Analogues of the new generation include cephalosporin antibiotics of the 4th and 5th generation. The first list is Cefpirom, Cefepim.

The second group includes Ceftaroline, Ceftobiprole, Ceftolozane.

These medicines active against more pathogens are extremely resistant to bacterial enzymes aimed at destroying drugs.

5th generation cephalosporins are able to suppress the proliferation of bacteria, their spectrum of activity is wider than that of other representatives this series funds.

In suspensions for children

As for small patients, it is preferable to give them the medicine in the form of a suspension. This is extremely convenient and painless, since many children are afraid of injections. Cefotaxime is not produced in this form, so patients are prescribed the following drugs: cefuroxime (Zinnat) and cefixime (Pancef, Ixim Lupin).

The first contains 125 mg of cefuroxime per 5 ml of solution, the second – 100 mg. Each bottle of products has a volume of 50 ml.

These drugs contain special measuring cups, with the help of which it is convenient to calculate the required dose, which is extremely important when treating small patients, since for them the amount of the drug is important to choose the right dose, otherwise you can get adverse reactions.

Review of doctors on analogues

Cefotaxime is used by doctors of various specialties, including

I like to use the Zinnat analogue for the treatment of urethral infections, Bladder and kidneys. The medicine is very effective, it begins to act in short time, is characterized by a small number of adverse reactions. For this reason, Zinnat is widely used in my practice.

Kondrashev I.I., urologist

I often prescribe Claforan to patients. It acts quickly, twice a day is enough, patients are also satisfied with its activity. Klaforan is well tolerated and suitable for young patients.

Ryabushko E.A., urologist