Cefotaxime

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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

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

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

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

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

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

Types of antibacterials
Antibacterials that inhibit protein synthesis (J01A, J01B, J01F, J01G, QJ01XQ)
30S
50S
Oxazolidinone (initiation inhibitors)
Peptidyl transferase
MLS (transpeptidation/translocation)
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
Extended
spectrum
Carbapenems / Penems
Cephems
Cephalosporins
Cephamycins
Carbacephems
1st generation
2nd generation
3rd generation
4th generation
5th generation
Monobactams
β-lactamase inhibitors
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


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


Antibacterials: others (J01X, D06AX)
Other/ungrouped


Oral Cephalosporins

Parenteral Cephalosporins

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Contributors: Prab R. Tumpati, MD