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Cefotaxime sodium is an organic compound with the chemical formula C16H16N5NaO7S2. It is a third-generation semi-synthetic cephalosporin. It is not as effective as cefazolin against Gram-positive bacteria. Enterococci are resistant to this product. It is ineffective against penicillin-resistant pneumococci. It has strong bactericidal activity against Gram-negative bacteria. Its antibacterial effect on Escherichia coli, H. influenzae, Klebsiella pneumoniae, Proteus mirabilis, and Salmonella is stronger than that of cefoperazone. It has a weak effect or is resistant to Bacteroides fragilis. Pseudomonas aeruginosa and Enterobacter cloacae are not sensitive to this product.
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Chemical Formula |
C16H16N5NaO7S2 |
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Exact Mass |
477.04 |
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Molecular Weight |
477.44 |
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m/z |
477.04 (100.0%), 478.04 (17.3%), 479.03 (9.0%), 478.04 (1.8%), 478.04 (1.6%), 480.04 (1.6%), 479.04 (1.4%), 479.05 (1.4%) |
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Elemental Analysis |
C, 40.25; H, 3.38; N, 14.67; Na, 4.82; O, 23.46; S, 13.43 |
Clinical application scope
Respiratory system infection
Cefotaxim sodium is widely used in the clinical treatment of various respiratory system diseases caused by sensitive bacteria. It is effective for acute and chronic bronchitis, bronchiectasis complicated with pneumonia, bronchopneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), tonsillitis, and peritonsillar abscess. These respiratory infections are often triggered by sensitive Gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae, as well as some Gram-positive bacteria.
Cefotaxim sodium, as a third-generation cephalosporin antibiotic, can effectively penetrate the respiratory tract tissue, kill the pathogenic bacteria by inhibiting the synthesis of bacterial cell walls, thereby quickly relieving patients' symptoms such as cough, expectoration, chest tightness, sore throat, and fever, and promoting the recovery of respiratory function.
Urinary system infection
Cefotaxim sodium also has a good therapeutic effect on urinary system infections, including pyelonephritis, cystitis, urethritis, and other common urinary tract infections. Urinary tract infection is one of the most common bacterial infections in clinical practice, mostly caused by pathogenic bacteria such as Escherichia coli and Proteus mirabilis invading the urinary tract. Cefotaxim sodium can be quickly absorbed into the blood after administration, and its concentration in urine can reach an effective antibacterial level.
It achieves the therapeutic purpose by specifically inhibiting the growth and reproduction of pathogenic bacteria in the urinary tract, relieving patients' frequent micturition, urgent micturition, dysuria, lumbago, and other discomfort symptoms, and preventing the progression of infection to more serious conditions such as renal damage.
Reproductive system infection
Cefotaxim sodium also shows significant therapeutic effects on reproductive system infections, including intrauterine infections, pelvic inflammatory disease, salpingitis, oophoritis, and other related infections. Reproductive system infections are often caused by a variety of mixed bacteria, such as Streptococcus agalactiae, Neisseria gonorrhoeae, and anaerobic bacteria.
Thanks to its broad-spectrum antibacterial activity, cefotaxim sodium can cover most of the pathogenic bacteria that cause reproductive system infections, effectively inhibit the proliferation of bacteria in the reproductive organs, reduce local inflammation and congestion, alleviate symptoms such as lower abdominal pain, abnormal vaginal discharge, and fever, and protect the reproductive health of patients.
Intestinal infection
Infectious enteritis, bacterial dysentery, and other intestinal infections are also within the scope of treatment with cefotaxim sodium. Intestinal infections are mostly caused by pathogenic bacteria such as Shigella, Salmonella, and Escherichia coli invading the intestinal tract, which can lead to symptoms such as abdominal pain, diarrhea, tenesmus, and bloody purulent stool. Cefotaxim sodium can inhibit the growth and reproduction of these pathogenic bacteria in the intestinal tract, reduce the damage of bacteria to the intestinal mucosa, alleviate intestinal inflammation, improve diarrhea and abdominal pain symptoms, and help restore the normal digestive function of the intestinal tract.
Antibacterial mechanism
Cefotaxime sodium belongs to the β - lactam class of antibiotics, and its antibacterial mechanism mainly exerts bactericidal effect by inhibiting the synthesis of bacterial cell walls. The bacterial cell wall is an important structure for bacterial survival and reproduction. Cefotaxim sodium can bind to penicillin binding proteins (PBPs) on the bacterial cell wall, thereby inhibiting the synthesis of the bacterial cell wall. When bacterial cell wall synthesis is inhibited, bacterial growth and reproduction are hindered, ultimately leading to bacterial death.
Drug interactions
Combined use with gentamicin or tobramycin:
When cefotaxim sodium is combined with gentamicin or tobramycin, it has a synergistic effect on Pseudomonas aeruginosa. This means that when the two drugs are used in combination, they can more effectively kill Pseudomonas aeruginosa and improve treatment efficacy.
Combined with Amikacin:
When used in combination with amikacin, cefotaxim sodium has a synergistic effect on Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. This synergistic effect can enhance the bactericidal effect of the two drugs and improve treatment efficiency.
Efficiency leap Precision and stability
Combined use with aminoglycoside antibiotics:
When cefotaxim sodium is used in combination with aminoglycoside antibiotics, renal function should be followed up. Because both drugs may have a certain impact on kidney function, close attention should be paid to changes in the patient's kidney function when used in combination.
Combined use with strong diuretics:
When high-dose cefotaxim sodium is used in combination with strong diuretics, attention should also be paid to changes in renal function. Strong diuretics may increase the burden on the kidneys, while cefotaxim sodium may also have some impact on kidney function, so caution should be exercised when using them in combination.
Dosages
Cefotaxime Sodium is an antibiotic administered intravenously or intramuscularly. The dosage is determined based on the severity of the infection, the patient's condition, and the physician's recommendation. Below is a detailed description of the dosage and administration guidelines:
Adult dosage: The daily dosage is generally 2-6g, divided into 2-3 intravenous injections or intravenous drips. For severe infections, 2-3g every 6-8 hours, and the maximum daily dosage does not exceed 12g; For the treatment of uncomplicated pneumococcal pneumonia or acute urinary tract infection, 1g every 12 hours. Gonorrhea: 1g intramuscular injection (single dose is sufficient).
Dosage for children: Newborns: 50 mg/kg every 12 hours for those aged 7 days or less; 50 mg/kg every 8 hours for those aged > 7 days. Children over 1 month old: 50mg/kg every 8 hours. When treating meningitis, the dose is increased to 75mg/kg every 6 hours. Both are given intravenously.
Prevention of infection: 1g intramuscularly or intravenously 0.5-1 hour before anesthesia for major surgical operations. 1g during the operation, 1g every 6-8 hours after the operation, for up to 24 hours.
Dosage for patients with severe renal impairment: When using this product, the dosage should be appropriately reduced. When the serum creatinine value exceeds 424mol/l (4.8mg) or the creatinine clearance rate is lower than 20mI/min, the maintenance dose of cefotaxime should be halved; When the serum creatinine value exceeds 751mol/l (8.5mg), the maintenance dose is 1/4 of the normal dose; for patients who need hemodialysis, 0.5-2g per day, but an additional dose should be used after dialysis.
Preparation methods
Intramuscular injection: 1 g of this product is dissolved in 4 ml of 1% or 2% lidocaine injection and injected into deep muscles to avoid pain; or dissolved in 4 ml of water for injection and injected into deep muscles.
Intravenous injection: 1 g of this product is dissolved in more than 10 ml of water for injection and injected intravenously over 3-5 minutes.
Intravenous infusion: 2 g of this product can be dissolved in 40 ml of water for injection or 40 ml of 10% glucose solution and dripped within 20 minutes. It can also be dissolved in 100 ml of isotonic solution or 10% glucose solution and dripped within 40-60 minutes.
adverse reactions
Allergic Reactions: It has the potential to induce allergic reactions, including skin rashes, itching, and in severe cases, anaphylactic shock. The risk of anaphylactic shock, though relatively low, is a serious concern, with some studies showing it accounting for up to 32.6% of all adverse reactions and 41.9% of allergic reactions. Anaphylactic shock typically occurs within minutes of intravenous administration but can also manifest later.
Gastrointestinal Distress: Can cause gastrointestinal side effects such as nausea, vomiting, abdominal discomfort, and diarrhea. These reactions are often due to the drug's irritation of the gastrointestinal mucosa.
Local Reactions: Local pain, tenderness, and warmth are common at the injection site, especially with prolonged or high-dose intravenous administration. The incidence of thrombophlebitis can be up to 20% in such cases.
Hematological Abnormalities: Less commonly, it may cause hematological abnormalities such as leukopenia, thrombocytopenia, and hemolytic anemia. These reactions are typically transient but should be monitored closely.
Renal and Hepatic Dysfunction: Long-term use or high doses may lead to renal and hepatic dysfunction, though these effects are generally reversible.
Central Nervous System Effects: In rare cases, it can cause central nervous system symptoms such as headache, dizziness, and even seizures, especially in patients with renal impairment.
Vitamin Deficiencies: May interfere with vitamin absorption, leading to deficiencies in vitamins K and B complex.
Cefotaxime Sodium, a third-generation cephalosporin, possesses several distinctive characteristics that make it a valuable antibacterial agent. Firstly, it exhibits a broad spectrum of antibacterial activity, particularly against Gram-negative bacteria, including powerful effects on Enterobacteriaceae. Secondly, it is highly stable against β-lactamases, making it effective against resistant strains. Thirdly, it achieves high concentrations in body fluids and tissues, including urine and bile, ensuring effective antibacterial action.
Drug Interactions
It may interact with other medications, leading to altered pharmacokinetics or pharmacodynamics. Some important drug interactions include:
Aminoglycosides: Concurrent administration of cefotaxime with aminoglycosides (e.g., gentamicin, tobramycin) may result in synergistic antibacterial activity against certain Gram-negative bacteria. However, this combination may also increase the risk of nephrotoxicity, particularly in patients with renal impairment. Close monitoring of renal function is recommended when these drugs are used together.
Probenecid: Probenecid, a uricosuric agent, inhibits the tubular secretion of cefotaxime, leading to increased plasma concentrations and prolonged elimination half-life. This interaction may be beneficial in patients with severe infections requiring higher drug levels, but it may also increase the risk of adverse effects.
Antacids and H₂-Receptor Antagonists: Antacids and H₂-receptor antagonists (e.g., ranitidine, cimetidine) may reduce the oral bioavailability of cefotaxime if administered concomitantly. However, since cefotaxime is administered parenterally, this interaction is of minimal clinical significance.
Oral Contraceptives: Cefotaxime may reduce the efficacy of oral contraceptives by altering gut flora and interfering with the enterohepatic circulation of estrogen. Women receiving cefotaxime therapy should be advised to use alternative methods of contraception during treatment.
Alcohol: Although there is no direct interaction between cefotaxime and alcohol, concurrent use may increase the risk of gastrointestinal adverse effects such as nausea and vomiting. Patients should be advised to avoid alcohol consumption during cefotaxime therapy.
It remains a vital antimicrobial agent with proven efficacy across diverse infections. Its broad spectrum, favorable pharmacokinetics, and low toxicity profile justify its continued use, particularly in severe and life-threatening conditions. However, the rise of resistance necessitates judicious use, guided by local susceptibility patterns and stewardship principles. Ongoing research into novel formulations (e.g., liposomal cefotaxime) and combination strategies offers hope for extending its clinical relevance in the era of antimicrobial resistance.
As healthcare providers navigate an increasingly complex landscape of infectious diseases, it stands as a testament to the enduring value of targeted, evidence-based antibiotic therapy.
FAQ
What is another name for cefotaxime sodium?
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Like other third-generation cephalosporins, it has broad spectrum activity against Gram positive and Gram negative bacteria. In most cases, it is considered to be equivalent to ceftriaxone in terms of safety and efficacy. Cefotaxime sodium is marketed under various trade names including Claforan (Sanofi-Aventis).
Is cefotaxime a strong antibiotic?
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Cefotiam is applied to treat bacterial infections caused by many enteric bacteria and skin infection-causing bacteria, exhibiting more effective potency against multiple enterobacteriaceae bacteria, including Escherichia coli, Enterobacteriaceae, Salmonella, Klebsiella, and indole-positive Proteobacteria.
How quickly does cefotaxime work?
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You should begin to feel better during the first few days of treatment with cefotaxime injection. If your symptoms do not improve or get worse, call your doctor.
Is cefotaxime a penicillin?
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Cefotaxime is an antibiotic. It belongs to a group of antibiotics that are called cephalosporins. These types of antibiotic are similar to penicillin. It can also be used to prevent and treat infections following surgical operations.
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