Cefotaxime - WikiMD's WELLNESSPEDIA

Cefotaxime

Cefotaxime is a third-generation Cephalosporin antibiotic. It was first patented in 1976 and came into medical use in 1980. Cefotaxime is used to treat a variety of bacterial infections, including those caused by Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae, Neisseria gonorrhoeae, and others.

Chemistry[edit]

Cefotaxime is a semi-synthetic, beta-lactam antibiotic, which is resistant to most beta-lactamases. It is derived from Cephalosporin C, a naturally occurring antibiotic produced by the fungus Acremonium. Cefotaxime works by inhibiting the synthesis of the bacterial cell wall, leading to cell death.

Pharmacology[edit]

Cefotaxime is administered either by intravenous or intramuscular injection. It is metabolized in the body and excreted in the urine. The half-life of cefotaxime is approximately one hour in adults.

Clinical Use[edit]

Cefotaxime is used to treat a wide range of infections, including pneumonia, meningitis, gonorrhea, and infections of the skin, urinary tract, and abdomen. It is also used for surgical prophylaxis in patients undergoing abdominal or pelvic surgery.

Side Effects[edit]

Common side effects of cefotaxime include rash, diarrhea, and changes in white blood cell count. Serious side effects may include Clostridium difficile infection, allergic reactions, and seizures.

Resistance[edit]

Resistance to cefotaxime and other cephalosporins can occur through several mechanisms, including the production of beta-lactamase enzymes, alteration of penicillin-binding proteins, and efflux pumps.

See Also[edit]

Types of antibacterials

Antibacterials that inhibit protein synthesis (J01A, J01B, J01F, J01G, QJ01XQ)

30S

Aminoglycosides (initiation inhibitors)

-mycin (Streptomyces)	- Streptomycin# - Dihydrostreptomycin - Neomycin# -- Framycetin -- Paromomycin# -- Ribostamycin - Kanamycin -- Amikacin# -- Arbekacin -- Bekanamycin -- Dibekacin - Tobramycin (+loteprednol) - Spectinomycin# - Hygromycin B - Totomycin - Apramycin - Nourseothricin
-micin (Micromonospora)	- Gentamicin# -- Netilmicin -- Sisomicin -- Micronomicin -- Plazomicin# -- Isepamicin - Verdamicin - Astromicin
other	- Butirosin

Tetracycline antibiotics (tRNA binding)

Tetracyclines	- Doxycycline# - Chlortetracycline - Clomocycline - Demeclocycline - Eravacycline - Lymecycline - Meclocycline‡ - Metacycline - Minocycline - Omadacycline - Oxytetracycline - Penimepicycline - Rolitetracycline - Sarecycline - Tetracycline#
Glycylcyclines	- Tigecycline

50S

Oxazolidinone (initiation inhibitors)

- Eperezolid - Linezolid# - Posizolid - Radezolid - Ranbezolid - Sutezolid - Tedizolid

Peptidyl transferase

Amphenicols

- Chloramphenicol# - Azidamfenicol - Thiamphenicol - Florfenicol

MLS (transpeptidation/translocation)

Macrolides	- Azithromycin# - Boromycin - Carbomycin - Carrimycin - Clarithromycin# - Dirithromycin - Erythromycin# - Flurithromycin - Gamithromycin - Josamycin - Kitasamycin - Midecamycin - Miocamycin - Nafithromycin - Oleandomycin - Rokitamycin - Roxithromycin - Solithromycin - Spiramycin - Telithromycin - Tildipirosin - Tilmicosin - Troleandomycin - Tulathromycin - Tylosin - Tylvalosin
Ketolides	- Telithromycin‡ - Cethromycin - Solithromycin†
Lincosamides	- Clindamycin# - Lincomycin - Pirlimycin
Streptogramins	- Pristinamycin (IA, IIA, IIB) - NXL103 (Flopristin, Linopristin) - Quinupristin/dalfopristin (Dalfopristin, Quinupristin) - Streptogramin A - Streptogramin B - Virginiamycin (S1)

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

Antibacterials active on the cell wall and envelope (J01C-J01D)

β-lactams
(inhibit synthesis
of peptidoglycan
layer of bacterial
cell wall by binding
to and inhibiting
PBPs, a group of
D-alanyl-D-alanine
transpeptidases)

Penicillins (Penams)

Narrow
spectrum

β-lactamase sensitive (1st generation)	- Benzylpenicillin (G)^# - Benzathine benzylpenicillin^# - Procaine benzylpenicillin^# - Phenoxymethylpenicillin (V)^# - Propicillin^‡ - Pheneticillin^‡ - Azidocillin^‡ - Clometocillin^‡ - Penamecillin^‡
β-lactamase resistant (2nd generation)	- Cloxacillin^# (Dicloxacillin - Flucloxacillin) - Oxacillin - Nafcillin - Methicillin^‡

Extended
spectrum

Aminopenicillins (3rd generation)	- Amoxicillin^# - Ampicillin^# (Pivampicillin - Hetacillin^‡ - Bacampicillin^‡ - Lenampicillin - Metampicillin^‡ - Talampicillin^‡) - Epicillin^‡
Carboxypenicillins (4th generation)	- Ticarcillin - Carbenicillin^‡ / Carindacillin^‡ - Temocillin^‡
Ureidopenicillins (4th generation)	- Piperacillin - Azlocillin^‡ - Mezlocillin^‡
Other	- Mecillinam (Pivmecillinam) - Sulbenicillin^‡

Carbapenems / Penems

- Carbapenems (Ertapenem

- Antipseudomonal (Doripenem - Imipenem - Meropenem) - Biapenem^‡ - Panipenem) - Penems (Faropenem - Ritipenem^§

- Sulopenem)

Cephems
Cephalosporins
Cephamycins
Carbacephems

1st generation	- Cefazolin^# - Cefalexin ^# - Cefadroxil - Cefapirin - Cefazedone^‡ - Cefazaflur^‡ - Cefradine^‡ - Cefroxadine^‡ - Ceftezole^‡ - Cefaloglycin^‡ - Cefacetrile^‡ - Cefalonium^‡ - Cefaloridine^‡ - Cefalotin - Cefatrizine^‡
2nd generation	- Cefaclor - Cefprozil - Cefuroxime - Cefuroxime axetil - Cefamandole^‡ - Cefonicid^‡ - Ceforanide^‡ - Cefuzonam^‡ - Cephamycin (Cefoxitin - Cefotetan - Cefminox^‡ - Cefbuperazone^‡ - Cefmetazole^‡) - Carbacephem (Loracarbef^‡)
3rd generation	- Cefixime^# - Ceftriaxone^# - Cefotaxime^# - Antipseudomonal (Ceftazidime^# - Cefoperazone) - Cefdinir - Cefcapene - Cefdaloxime - Ceftizoxime - Cefmenoxime - Cefpiramide - Cefpodoxime - Ceftibuten - Cefditoren - Cefotiam^‡ - Cefetamet^‡ - Cefodizime^‡ - Cefpimizole^‡ - Cefsulodin^‡ - Cefteram^‡ - Ceftiolene^‡ - Oxacephem (Flomoxef - Latamoxef^‡)
4th generation	- Cefepime - Cefozopran^‡ - Cefpirome - Cefquinome^‡
5th generation	- Ceftaroline fosamil - Ceftolozane - Ceftobiprole

Monobactams

- Aztreonam

- Tigemonam^‡ - Carumonam^‡

- Nocardicin A^‡

β-lactamase inhibitors

- Penam (Sulbactam

- Tazobactam) - Clavam (Clavulanic acid) - non-β-lactam (Avibactam - Durlobactam - Relebactam

- Vaborbactam)

Polypeptides

Lipopeptides	- Insert into bacterial cell wall causing perforation and depolarization: Daptomycin - Surfactin
Other	- Inhibits PG elongation and crosslinking: Ramoplanin^§

Intracellular

- Inhibit PG subunit synthesis and transport: NAM synthesis inhibition (Fosfomycin)

- DADAL/AR inhibitors (Cycloserine)

- bactoprenol inhibitors (Bacitracin)

Other

- Hydrolyze NAM-NAG

- - lysozyme - Tyrothricin - - Gramicidin - - Tyrocidine - Isoniazid^#

- Teixobactin

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

Antibacterials that inhibit nucleic acid (J01E, J01M)

Antifolates (inhibit bacterial purine metabolism, inhibiting DNA/RNA synthesis)	DHFR inhibitors - 2,4-Diaminopyrimidine (Brodimoprim - Iclaprim - Ormetoprim - Pyrimethamine - Tetroxoprim - Trimethoprim) Sulfonamides (DHPS inhibitors) Short-acting - Sulfisomidine - Sulfamethizole - Sulfadimidine (Sulfamethazine - Sulfadimerazine - Sulfadimezine) - Sulfapyridine (Sulfasalazine) - Sulfafurazole (Acetyl sulfisoxazole) - Sulfanilamide (Prontosil) - Sulfathiazole (Phthalylsulfathiazole - Succinylsulfathiazole) - Sulfathiourea Intermediate-acting - Sulfamethoxazole - Sulfadiazine - Sulfamoxole Long-acting - Sulfadimethoxine - Sulfadoxine - Sulfalene - Sulfametomidine - Sulfametoxydiazine - Sulfamethoxypyridazine - Sulfaperin - Sulfamerazine - Sulfaphenazole - Sulfamazone Other/ungrouped - Mafenide - Sulfacetamide - Sulfaclozine - Sulfadicramide - Sulfaguanidine - Sulfametrole - Sulfanitran Combinations - Trimethoprim/sulfamethoxazole - Ormetoprim/sulfadimethoxine - Pyrimethamine/dapsone - Pyrimethamine/sulfadoxine Other DHPS inhibitors - Acediasulfone - Dapsone - Solasulfone - Sulfoxone
Quinolones (inhibit topoisomerase/DNA gyrase)	1st Generation - Cinoxacin - Flumequine - Nalidixic acid - Oxolinic acid - Pipemidic acid - Piromidic acid - Rosoxacin Fluoroquinolones 2nd Gen - Ciprofloxacin - Ofloxacin - Enoxacin - Fleroxacin - Lomefloxacin - Nadifloxacin - Levonadifloxacin - Alalevonadifloxacin - Norfloxacin - Pefloxacin - Rufloxacin 3rd Gen - Levofloxacin - Balofloxacin - Grepafloxacin - Pazufloxacin - Sparfloxacin - Temafloxacin - Tosufloxacin 4th Gen - Besifloxacin - Delafloxacin - Gatifloxacin - Finafloxacin - Gemifloxacin - Moxifloxacin - Clinafloxacin - Garenoxacin - Prulifloxacin - Sitafloxacin - Trovafloxacin - Alatrofloxacin Veterinary use - Danofloxacin - Difloxacin - Enrofloxacin - Ibafloxacin - Marbofloxacin - Orbifloxacin - Pradofloxacin - Sarafloxacin Newer non-fluorinated - Nemonoxacin - Ozenoxacin Related (DNA gyrase) - Aminocoumarins (Novobiocin)
Anaerobic DNA inhibitors	Nitroimidazole derivatives - Secnidazole
RNA synthesis inhibitors	Rifamycins - Rifampicin - Rifabutin - Rifapentine - Rifaximin - Rifalazil Lipiarmycins - Fidaxomicin