Saturday, November 29, 2014

Cefotaxime (Claforan®)

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Overview


  • Cefotaxime is an antibiotic. It is further categorized as a third generation cephalosporin given by intramuscular or intravenous injection to treat susceptible infections. 
  • It is bactericidal and works by inhibiting mucopeptide synthesis in the bacterial cell wall. 
  • There are many susceptible organisms to cefotaxime that include gram positive and gram negative organisms. Specific organisms include Gram-positive: Staphylococci, beta-hemolytic Streptococci; Streptococcus pneumoniae and S. pyogenes. Gram-negative: Acinetobacter spp; Bacteroides spp; Citrobacter spp; Enterobacter spp; Escherichia coli; Haemophilus influenzae and H. parainfluenzae; Klebsiella spp; Proteus morganii, mirabilis, and vulgaris; Providencia rettgeri; Pseudomonas aerogenosa; and Serratia spp
  • Cefotaxime is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug. 

    Brand Names and Other Names
  • This drug is registered for use in humans only.
  • Human formulations: Claforan® (Hoechst Marion Roussel)
  • Veterinary formulations: None

    Uses of Cefotaxime
    Cefotaxime is used in both dogs and cats to treat a variety of bacterial infections, including: 
  • Lower respiratory tract infections
  • Uterine infections
  • Dermatological infections
  • Intra-abdominal infections
  • Bone and joint infections
  • CNS infections
  • Treatment of bacteremia/sepsis

    Precautions and Side Effects

  • Cefotaxime should not be used in animals with known hypersensitivity or allergy to it or any related antibiotic. 
  • The most frequent adverse reactions are:

    1) Injection site inflammation following intravenous administration and pain, induration, and tenderness after intramuscular injection.

    2) Hypersensitivity reactions - rash, pruritus, fever, eosinophilia, urticaria, andanaphylaxis.

    3) Gastrointestinal problems such as colitis, diarrhea, and vomiting. Symptoms of pseudomembranous colitis may appear during or after treatment.

  • Less frequent adverse reactions: Potentially life-threatening arrhythmias following bolus administration via central venous catheter; hematological disturbances, including neutropenia, leukopenia, eosinophilia, thrombocytopenia and agranulocytosis. Hemolytic anemia has been reported to occur in humans treated with cefotaxime. Transient elevations in AST, ALT, LDH, and alkaline phosphatase levels have occurred in human patients. Interstitial nephritis and transient elevations of BUN and creatinine have developed in humans treated with this antibiotic. 
  • The dose of cefotaxime should be reduced in patients with pre-existing renal disease. 

    Drug Interactions

  • Cefoxitin may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with cefotaxime. Such drugs include certain other antibiotics.
  • Cefotaxime solutions are physically incompatible with aminoglycoside solutions. 
  • In addition, cefotaxime exhibits pharmacological interactions with the following drugs:

    1. Aminoglcosides – aminoglycoside toxicity may be enhanced (monitor renal function carefully)

    2. Anticoagulants – hypoprothrombinemic effects of anticoagulants may be increased

    3. Polypeptide antibiotics – their nephrotoxic effects may be enhanced. Monitor renal function.

    4. Probenecid – inhibits renal tubular secretion of cefotaxime 

    How Cefotaxime is Supplied

  • Powder for Injection: 500 mg, 1 g, 2 g, 10 g. 
  • Injection (premixed in 50 mL): 1 g and 2 g. 

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian. 
  • In dogs, the usual dose is 10 to 40 mg per pound (20 to 80 mg/kg) every 6 to 12 hours subcutaneously, intramuscularly or intravenously.
  • In cats, the usual dose is 10 to 40 mg per pound (20 to 80 mg/kg) every 6 hours subcutaneously, intramuscularly or intravenously.
  • After receiving cefotaxime many pets are sent home with a prescription of an oral cephalosporin, similar to cefotaxime.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.
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