Cefotaxime is an antibiotic. The active ingredient belongs to the third-generation cephalosporins.
What is cefotaxime?
Cefotaxime is the name given to a broad-spectrum antibiotic that belongs to group 3a of cephalosporins. The active ingredient is used to treat bacterial infections. Just like other cephalosporins, cefotaxime is able to kill bacteria. In doing so, the drug inhibits bacterial cell wall synthesis. Cefotaxime was approved for use in the 1980s. In Germany and Austria, the prescription antibiotic is available as a monopreparation under the name Claforan. In addition, various generics are offered.
Pharmacologic action
The mode of action of cefotaxime is based on the fact that the antibiotic prevents bacteria from building their cell wall. For this purpose, it performs a blockade of the enzyme transpeptidase. As a result of this process, weak spots are formed within the cell envelope of the germs. The weak spots cause the cell wall of the bacteria to tear, which ultimately results in the death of the pathogens. Unlike group 1 cephalosporins such as cefazolin, cefotaxime is more effective against gram-negative bacteria. These include Enterobacteriaceae, meningococci and gonococci. A weakness of cefotaxime, however, is that it is less effective against pseudomonads than other cephalosporins from group 3a, which include ceftazidime, ceftriaxone and cefmenoxime. Cefotaxime may also be ineffective against certain germs in which resistance to antibiotics already exists. Bacterial species against which the drug is effective include, for example, Salmonella, Enterobacter, Shigella, Escherichia coli, Pneumococcus, Strepotococcus viridans, Proteus vulgaris, Neisseria gonorrhoeae (gonococci), Pasteurella, Klebsiella, and anaerobes. In the gram-positive range, the efficacy of the agent is insufficient against staphylococci. The half-life of cefotaxime in adults is about 60 minutes. In seniors or babies, it is often significantly longer. The antibiotic is excreted primarily through the kidneys.
Medical use and application
Cefotaxime is used against severe bacterial infections, which can even be life-threatening. The body regions that are mostly treated include the urinary tract, such as the urethra, ureters, urinary bladder, and kidneys; the respiratory tract; the ear, nose, and throat; and the skin. Common indications for the use of cephalosporin include pneumonia, sepsis, peritonitis, abdominal infections, meningitis, endocarditis, bone infections, and soft tissue infections. If gaps in efficacy occur, these are closed by administering further antibiotics such as acylaminopenicillin or aminoglycoside. Another treatment area for cefotaxime is neuroborreliosis, which is a manifestation of Lyme disease. This disease is transmitted by ticks and caused by the bacterium Borrelia burgdorferi. Cefotaxime is administered past the intestine through an infusion.
Risks and side effects
Adverse side effects are possible in some patients as a result of taking cefotaxime. In most cases, these include a deficiency of platelets, the development of immature blood cells, allergic skin reactions such as itching, rash, and hives, and drug fever. In addition, the concentration of urea and creatinine in the blood may increase. Side effects are also sometimes seen at the site of administration itself. These include pain at the injection site, tissue hardening or inflammatory reactions on the vein wall. Other occasional side effects include gastrointestinal problems such as diarrhea, abdominal pain, loss of appetite, nausea and vomiting, bloody inflammation of the colon or small intestine, inflammation of the kidneys, and additional infections caused by resistant bacteria. If a hypersensitivity reaction to cefotaxime occurs, accompanied by bronchial spasms, swelling of the face or shock, therapy with the antibiotic must be stopped immediately. If there is impaired kidney function or a tendency to allergy, a thorough risk-benefit assessment by the attending physician is required.No experience with the administration of cefotaxime exists during pregnancy. No negative effects on the offspring have been observed in animal studies. Nevertheless, if treatment is given during pregnancy, strict monitoring by the physician is recommended. During breastfeeding, the use of cefotaxime can disrupt the intestinal flora of babies, as the antibiotic passes into breast milk, albeit only in small amounts. Subsequently, the affected infants usually suffer from diarrhea. In principle, however, it is possible to treat newborns with the active substance. The simultaneous use of cefotaxime and other drugs occasionally leads to interactions. Thus, the positive effect of the antibiotic is weakened if a combination with chloramphenicol, erythromycin, sulfonamides or tetracyclines takes place. The simultaneous administration of the gout medication probenecid results in an impediment to the excretion of cefotaxime from the body. Because of this, the concentration of the drug within the blood is prolonged and there is a risk of more severe side effects.
