Parenteral Manual

Cefotaxime sodium

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
CLAFORAN®
Classification: 
Antibiotic
Original Date: 
August 2005
Revised Date: 
January 2021
Indications: 
  • Third generation cephalosporin for treatment of infections caused by susceptible strains of bacteria
Reconstitution and Stability: 

VIAL SIZE

 STERILE WATER for INJECTION REQUIRED

FINAL CONCENTRATION

1,000 mg

9.6 mL

100 mg/mL
  • Reconstituted solutions stable 12 hours at room temperature, 24 hours when refrigerated.
  • Solution colour ranges from light yellow to amber
  • DO NOT USE if solution is dark brown

 

Compatibility: 

- Solutions Compatible: dextrose solutions up to D10W, 0.9% NS, dextrose-saline combinations, ringer's lactate

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: morphine, TPN (amino acids/dextrose), potassium chloride

- Incompatible:  alkaline solutions, aminophylline, sodium bicarbonate, vancomycin, aminoglycoside antibiotics; administration of aminoglycoside and beta lactam antibiotics should be separated

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM

YES, deep into large muscle
Usual dilution: 300 mg/mL- dilute 1 g vial with 3 mL sterile water for injection

- doses as large as 2 g should be divided between different sites
IV Direct

YES .  Maximum 2 g/dose IV direct.  Doses > 2 g give IV intermittent
Usual dilution: 100 mg/mL
- 20 mg/mL for dose less than 200 mg
Infusion time: 3-5 minutes (rapid IVP <1 minute may cause life-threatening arrhythmias)
IV Intermittent Infusion

YES
Usual dilution: 100 mg/mL

- 20 mg/mL for dose less than 200 mg
Infusion time: 15-30 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

PEDIATRIC:  

Usual dose:

  • 200 mg/kg/day IM/IV divided Q 6H
  • Maximum: 2 g/dose (8 g/day)  

Suspected bacterial meningitis

  • 300 mg/kg/day IM/IV divided Q6H
  • Maximum: 3 g/dose (12 g/day )

CF Dosing:

  • 300mg/kg/day IV divided every 4 - 6 hours
  • Maximum: 2000mg/dose (12g/day)

DOSAGE ADJUSTMENT IN RENAL IMPAIRMENT:

  • CrCl < 20 mL/min: reduce dose by 50%        
                  or      
  • CrCl > 50 mL/min: administer full dose Q6H
    CrCl 10-50 mL/min: administer full dose Q8-12H
    CrCl <10 mL/min: administer full dose Q24H
Potential hazards of parenteral administration: 
  • Local reactions at injection site:  inflammation after IV administration, pain, induration, tenderness after IM injection
  • Hypersensitivity reactions:  rash, pruritus, bronchospasm, anaphylaxis, serum sickness
  • Possible cross-sensitivity with other beta-lactam antibiotics (ie. penicillins, cephalosporins)
  • Gastrointestinal:  diarrhea, nausea, vomiting, colitis
  • Hematologic:  mild reversible leukopenia, granulocytopenia, thrombocytopenia
  • Transient elevations in hepatic enzymes, BUN and/or serum creatinine
Notes: 
  • Monitor renal, hepatic and hematologic function
  • Sodium content is 2.2 mmol/gm of cefotaxime

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