How is cefotaxime diluted for injection? Antibiotic biochemist cefotaxime - “cefotaxime is the most common antibiotic for intramuscular injections. I’ll tell you how to dilute and dial the required dosage. my experience of using it." Medic Kinetic Features

Cefotaxime is an effective antibacterial drug wide range action that helps to quickly cope with various infectious and inflammatory diseases of the body.

This drug has high antimicrobial sensitivity against many gram-positive or gram-negative bacterial pathogens(staphylococci, streptococci, pneumococci, etc.).

Cefotaxime is prescribed for complex treatment many infectious diseases respiratory organs, urinary and respiratory systems, various bacterial inflammatory processes affecting the kidneys, soft fabrics skin, etc.

After intramuscular use, the drug is mainly excreted from the body by the kidneys throughout the day.

Main indications for the use of Cefotaxime:

• inflammatory diseases respiratory system(bronchitis, pneumonia, pleurisy, etc.);
• infections genitourinary system(cystitis, pyelonephritis, glomerulonephritis);
• acute tonsillitis (tonsillitis);
• otitis media (ear inflammation);
• soft tissue or bone infections (abscess, burn or purulent wounds, furunculosis, osteomyelitis);
• gonorrhea;
• severe inflammatory heart disease (endocarditis);
• septicemia;
• Lyme disease;
• prevention of the development of postoperative infections;
• gynecological diseases;
• joint infections;
• peritonitis ( purulent inflammation abdominal cavity);
• sepsis.

Attention: Before using Cefotaxime, it is recommended to consult with a qualified physician!

The drug is produced in the form of a soluble powder for the preparation of a solution for injection.

How to inject Cefotaxime?

Daily dose Cefotaxime for adults is 1-2 g and is usually prescribed 1-2 r. per day in the form of intravenous or intramuscular administration.

For children, this drug is prescribed by the attending physician absolutely individually for each child based on his body weight and the severity of a particular disease in the body.

For intramuscular injections, 0.5 or 1 g of Cefotaxime is dissolved in 2-4 ml. sterile water and injected deep into gluteal muscle.

For the treatment of fairly severe inflammatory processes, this antibacterial drug is prescribed for 2 g every 12 hours.

The maximum daily dose of Cefotaxime for adults should not exceed more than 4-6 g, as this may negatively affect the general condition of the body.

Contraindications to the use of Cefotaxime

• hypersensitivity (increased sensitivity of the body to the main active ingredients of the drug);
• enterocolitis;
• pregnancy and lactation (breastfeeding);
• bleeding;
• acute renal or liver failure.

Side effects of Cefotaxime

The most common adverse reactions that occur with long-term use of this antibacterial drug, there are:

• local allergic manifestations on the skin (urticaria, increased itchy skin, redness);
• violation digestive system(nausea, diarrhea, vomiting, constipation);
• pyelonephritis;
• increased body temperature;
• anaphylactic shock;
• pain in the abdomen;
• intestinal dysbiosis;
• superinfection;
• leukopenia;
• headache;
• pain at the injection site of the drug.

Remember: to prevent possible development anaphylactic shock After using Cefotaxime, each patient must be tested for the individual sensitivity of the body to antibiotics before its administration!

With the development of any adverse reactions After administration of Cefotaxime, it is recommended to consult with your doctor!

In this article, we looked at what Cefotaxime helps with, as well as how to inject it correctly.

Cefotaxime is classified as a third generation cephalosporin antibiotic. The drug has strong action, used in treatment serious illnesses caused by infection internal organs, respiratory organs, genitourinary system. Cefotaxime, doses described below, is approved for the treatment of people suffering from immunodeficiency.

The drug is produced in the form of a powder for the preparation of injections for injections. The package contains one bottle, calculated as a single dose. Cefotaxime is for injection use only.

Pharmacological properties

The drug cefotaxime is intended for parenteral use. Has a broad-spectrum bactericidal effect. Highly effective against infections caused by gram-negative bacteria resistant to other antibiotics:

• Citobacter,
• E. coli
• Proteus indole,
• Proteus mirobilis,
• Ptovidencia,
• Serratia,
• Klebsiella,
• Haemophlus influenzae,
• some strains of the genus Pseudomonas.

Less effective against gram-positive cocci and staphylococci. The drug is resistant to betalactamases secreted by gram-negative bacteria.

Indications for use

Cefotaxime is prescribed for:

• infections of drug-sensitive microorganisms (usually gram-negative);
• urinary infections and respiratory tract, kidney;
• infections of the nose, throat, ear, endocarditis, septicemia, meningitis;
• infections of the abdominal cavity and bones;
• gynecological infections, gonorrhea;
• wound and burn infections, etc.

Contraindications

Cefotaxime is contraindicated in persons with hypersensitivity to antibiotics of this group, as well as cross allergies between cephalosporins and. In patients with impaired liver and kidney function, cefotaxime is prescribed with caution. Children under 2.5 years of age should not be given intramuscular administration of cefatoxime.

Instructions for use

Cefotaxime is administered intravenously and intramuscularly.

• Intramuscular injection consists of 0.5 g of the drug dissolved in 2 ml of water intended for injection. Solvent at intramuscular injection 1% lidocaine can be used: 2 ml and 0.5 g of antibiotic. The injection is given deep into the gluteal muscles.
• Intravenous injection consists of 0.5-1 g of cefotaxime dissolved in 4 ml of water intended for injection. Injected slowly over 3-5 minutes.
• For IVs: 2 g of antibiotic is dissolved in 100 ml of NaCl saline solution or 5% glucose solution. Drip administration lasts 50-60 minutes.

Dosage of the drug

• for adults and children aged 12 years and older, 1 g is prescribed every 12 hours. For especially severe infections the dose can be increased to 3-4 g per day (3-4 injections of 1 g of the drug). Maximum dose can reach 12 g per day.
• for newborns and children under 12 years of age, the drug is calculated at 50-100 mg per 1 kg of body weight per day. The interval between injections is 6-12 hours.
• Premature newborns should not be prescribed doses higher than 50 mg per 1 kg of body weight per day. If renal function is impaired, the dose is reduced.

If creatinine clearance is below 10 ml/min, then daily dosage cefotaxime is reduced by 2 times.

Drug interactions

When prescribing cefotaxime and potentially nephrotoxic drugs (furosemide, aminoglycoside antibiotics) simultaneously, renal function must be monitored due to the nephrotoxic effect of the latter. It is possible that a false-positive Coombs test and sugar in the urine may appear when determined by neonesymatic methods (Benedict's method). Cefotaxime solution cannot be combined with solutions of other antibiotics in the same dropper or syringe.

Side effects

Possible allergic reactions:

• fever;
• skin rash;
• anaphylactic shock;
• digestive disorders in the form of dyspeptic symptoms;
• rarely pseudomembranous colitis.

Side effects of the drug manifest themselves in disorders functional tests liver, increased number of losinophils, leukopenia, agranulocytosis, neutropenia, hemolytic anemia, increasing the level alkaline phosphatase and the amount of nitrogen in the urine. There may be pain, swelling, and redness at the injection site. Possible increase in body temperature.

Often, most diseases have to be treated with antibacterial drugs. One of them is Cefotaxime. The medication is available in the form of a powder that must be diluted.

Action of Cefotaxime

Cefotaxime is a broad-spectrum antibiotic that belongs to the group of 3rd generation cephalosporins. The medication has an antibacterial mechanism of action on pathogenic microorganisms. Effective against many gram-positive and gram-negative bacteria resistant to penicillin, aminoglycosides and sulfonamides.

Mechanism antimicrobial action medications are associated with inhibition of the activity of the transpeptidase enzyme, blockade of peptidoglycan and destruction of the mucopeptide of the cell wall of microorganisms. The drug is administered only intravenously or intramuscularly.

Cefotaxime during lactation ( breastfeeding, GV): compatibility, dosage, elimination period

Dilution of antibiotics

LIDOCAINE, local anesthetic, instructions, mechanism of action, side effects

The antibacterial agent accumulates well in the tissues in which inflammatory processes. It is also concentrated in the heart muscle, subcutaneous fatty tissue, gall bladder and skin. Easily penetrates into the spinal, pleural and synovial fluid. The medication causes almost no damage to the liver. Excreted 90% in urine.

Action of Lidocaine

The drug has local anesthetic and antiarrhythmic effects. It is used for conduction, infiltration and terminal anesthesia. The anesthetic effect occurs due to inhibition of nerve conduction, due to the blockade of sodium channels in nerve fibers and endings.

The antiarrhythmic effect is due to the ability of the drug to increase the permeability of membranes to potassium and block sodium channels and stabilize cell membranes.

Can I take it at the same time?

Since Cefotaxime injections are very painful, it is recommended to mix the drug with lidocaine to dull the pain.

How to dilute Cefotaxime with lidocaine?

The drugs are diluted only for intramuscular injections in the proportion: 0.5 g of Cefotaxime per 2 ml of 1% lidocaine solution. For a dose of 1 g you will need 4 ml of anesthetic liquid. You can also dilute 1 g of Cefotaxime in powder form with water for injection (2 ml) and 2 ml of lidocaine (1%).

An anesthetic liquid is injected into the antibiotic bottle using a syringe. After this, the bottle of antibiotic is thoroughly shaken so that all the ingredients are mixed until smooth.

Mode of application

Before administering the drug, you must do skin test for sensitivity to antibiotics and lidocaine.

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Dosage regimen:

1. For adults, a single dose is 1 g every 12 hours. If necessary, the doctor can increase the dosage to 2 g every 12 hours or increase the number of injections to 3-4 times a day. The maximum daily dose is 12 g.
2. In case of impaired renal function, half the dosage is administered.
3. In the presence of acute gonorrhea, the medication should be administered once in a dose of 0.5-1 g.
4. Children weighing up to 50 kg (over 2.5 years) are prescribed a dosage of 50-180 mg/kg in 4-6 administrations. IN difficult situations Prescribe 100-200 mg of the substance per 1 kg of weight. The maximum daily volume is 12 g.

The solution is injected slowly and deeply into the gluteal muscle. After completing the manipulation, it is necessary to massage the injection site with alcohol-preserved cotton wool to prevent the formation of a lump. The solution cannot be prepared for future use. The course of treatment is determined individually.

Prolonged diarrhea may occur after starting treatment. In this case, it is necessary to stop therapy with this drug.

Contraindications to the use of Cefotaxime and Lidocaine

It is prohibited to give injections under the following conditions and pathologies:

• individual intolerance to Cefotaxime or Lidocaine;
• the appearance of allergies;
• 1st and 4th trimesters of pregnancy;
• lactation period;
• presence of bleeding;
• enterocolitis;
• acute colitis;
• children's age up to 2.5 years.

Injections should be prescribed with caution to people suffering from impaired liver and kidney function.

Side effects of Cefotaxime and Lidocaine

During treatment, the following may occur: negative manifestations, How:

• allergic reactions: rash, urticaria, fever, Quincke's edema;
• vomit;
• nausea;
• pain in the abdominal cavity;
• intestinal disorder;
• jaundice;
• colitis;
• changes in blood composition;
• migraine;
• soreness and hardness at the injection site;
• interstitial nephritis;
• hemolytic anemia.

Whenever side effects you need to consult a doctor.

Cefotaxime is a drug belonging to the group of latest generation antibiotics.

Due to its composition and pharmacological action, it is used to treat the most various diseases infected nature.

Presented in the form of a white powder, sold in glass bottles. The powder is used to prepare a solution.

The white powder of the drug is presented in the form sodium salt and consists of anhydrous cefotaxime.

The drug is administered intramuscularly or intravenously.

pharmachologic effect

The drug acts as bactericidal agent, since it is active against gram-positive and gram-negative microorganisms.

In addition, it has a broad spectrum antimicrobial effect. Due to its composition, it is often used in the treatment of infectious diseases of the kidneys and lungs.

Pharmacokinetics of the drug

Cefotaxime is a quickly absorbed drug. Rapid absorption is noted - within 5 minutes after application the constituent components enter the blood and increase performance.

The biological availability of the drug is 95%. Outputting the presented medicine out of the body within 1-1.5 hours, depending on the method of administration.

Up to 40% of the constituent components are excreted from the body in the urine. The remaining part of the substances turns into metabolites.

Mechanism of action

After administration of the drug occurs active destruction cell walls existing microorganisms.

Due to the destruction of the wall, their breathing is significantly impaired, as a result of which microorganisms die and their reproduction stops.

It should also be noted that due to the destruction of cells, fewer toxins enter the human body and harmful substances, which provide adverse effect on general state And further development diseases.

Use of the product for treatment and prevention

Indications for use of Cefotaxime:

Contraindications for use

Despite its useful pharmacological actions, Cefotaxime has many contraindications.

These include:

• individual intolerance and hypersensitivity to constituent components drug – to penicillins and cephalosporins;
• cannot be used for treatment during pregnancy and lactation;
• should not be used to treat diseases in children under two years of age.

Due to its rather serious contraindications, for example, hypersensitivity to components, the drug is used to treat diseases only as prescribed by a doctor.

Assignment scheme

Before using Cefotaxime, you should carefully read the instructions for use and permissible dosages drug.

Use of injection solution

Preparation of the solution requires compliance with the rules and dosage of the drug, which differ significantly depending on the method of administration.

There are three methods of treatment using the presented medicine:

1. Intravenous injection– per 1 g of active substance there are 4 ml of special sterile water intended for preparing the solution. The prepared injection composition is injected into the vein slowly, over at least 3 minutes.
2. Intravenous infusion– use 1-2 g active substance and 50-100 ml of solvent. The composition of the solvent may vary depending on the nature and severity of the disease. A solution of sodium chloride with percentage at 0.9%, as well as glucose 5%. The infusion time is at least 50-60 minutes.
3. Intramuscular injection– the method of dissolving the active substance is the same as in the case of intravenous injection. A 1% lidocaine solution can also be used as a solvent.

Compliance with the proportions in preparing the solution for injection is very important. The slightest mistakes can lead to an overdose and side effects.

Details on how to dilute antibiotics:

Basic doses

The dosage of Cefotaxime may vary dramatically depending on the degree and nature of the disease.

Specialist after necessary examination will draw up a drug administration regimen and dosage.

1. Treatment of simple infections without complications carried out by injecting the solution every 8-12 hours. To prepare the solution, 1 g of the active ingredient is used.
2. Infections moderate severity require administration of the drug every 12 hours, where 1-2 g of the active substance is used for preparation.
3. Serious illnesses require administration of the drug every 4-8 hours. The solution is made using 2 g of active substance.
4. As a preventive measure no more than 1 g of substance is used in preparing the solution. The frequency of injections should not exceed 6 hours.

The severity of the disease will be determined only by the attending physician based on the data obtained from the examination. Independent use and “prescribing” of the drug is strictly prohibited.

Overdose and additional instructions

If the dosage of the drug is not observed, unpleasant side effects may occur. side effects, which will only aggravate the already serious condition of the patient.

To the number side effects include nausea and vomiting, headaches and dizziness, increased or decreased blood pressure, diarrhea or constipation, skin rashes.

Among the most dangerous side effects include convulsions and increased body temperature with fever. True, this is only possible in the case of a fairly serious overdose.

When using the medicine as treatment and prevention, you should remember:

1. Side effects may occur in the first 2-3 days of using the drug. In most cases, in such situations, the medication is discontinued or the dosage and regimen of use are revised.
2. Drinking alcohol during treatment is strictly contraindicated. since this combination can lead to abdominal pain and other side effects.
3. Interaction with others medicines may lead to bleeding and skin lesions . The specialist who determines the treatment regimen takes this factor into account.
4. Prohibited for use during pregnancy and lactation – active substance penetrates the placenta and enters breast milk.
5. Children can only take this product from 2.5 years of age.. IN in case of emergency prescribed to premature and newborn babies. The dosage of the drug in one injection should not exceed 50 mg/kg.

The drug is subject to careful study and careful use, since chemical composition The drug can cause many side effects and lead to deterioration of health.

This is important - the opinion of doctors and patients

In order to know how effective and safe Cefotaxime is, as well as the nuances of its use, we recommend studying reviews from patients and specialists.

In case of severe and urinary system I always prescribe Cefotaxime to my patients. This drug has already proven itself as a fast-acting drug.

In case of non-compliance with the dosage, problems are noted in the form of side effects.

Petr Valentov, urologist, Moscow

I often have exacerbations and... I dropped some medicine. I have not suffered from pain or other troubles for several months now.

Tatyana Somova, 29 years old, St. Petersburg

I work as a loader, so a slight breeze is dangerous for me. With pyelonephritis, he is immediately taken away in an ambulance. They always inject Cefotaxime. After just a couple of days, the first symptoms and pain disappear.

Now they use this remedy as a preventive measure. The doctor prescribed it. Helps.

Oleg Grishin, 41 years old, Vladivostok

From all the available reviews about treatment with this drug, we can conclude that Cefotaxime has positive impact on the body in the treatment and prevention of inflammatory and infectious diseases.

During use, it is important to follow the dosage prescribed by your doctor.

Purchase and storage

Cefotaxime is available in glass bottles, the price of one is 1 gram. active drug is no more than 25 rubles.

The shelf life of the drug is 2 years. Storage temperature should not exceed +25 degrees Celsius.

The sale of the medicine is carried out only with a prescription from a doctor.

If there is no medicine in the pharmacy

Among the most famous analogues of Cefotaxime are:

1. Ceftriaxone. This analogue has a similar composition and effect. However, as a side effect, bile stagnation is also noted here, which was not detected in Tsifotaxime. Therefore, the answer to the question of whether it is better to use Cefotaxime or Ceftriaxone is obvious.
2. Claforan. This analogue is no different from Tsifotaxim. But due to the fact that the drug is imported, its price is higher and lies within 120 rubles.

Instructions for medical use medicine

Cefotaxime

Tradename

Cefotaxime

International nonproprietary name

Cefotaxime

Dosage form

Powder for solution for injection 0.5 g and 1.0 g

1 bottle contains

active substance - cefotaxime in terms of 100% substance (in the form of cefotaxime sodium) 0.5 g or 1.0 g

Description

White or white with yellowish tint powder, hygroscopic

Pharmacotherapeutic group

Antibacterial drugs for systemic use. β-lactam antibacterial drugs others. Third generation cephalosporins

PBX code J01DD01

Pharmacological properties

Pharmacokinetics After intravenous administration, the maximum concentration of cefotaxime in blood plasma (Cmax) is achieved after 5 minutes and is 100 μg/ml after administration of 1.0 g and 214 μg/ml after administration at a dose of 2.0 g. After intramuscular administration, Cmax of cefotaxime is achieved after 1.0 -1.5 hours. The therapeutic concentration of cefotaxime is 0.5-50 mcg/ml.

In the blood, it reversibly binds to plasma proteins (25-40%), mainly to albumin. Easily penetrates histohematic barriers into organs and tissues (myocardium, bones, gallbladder, skin, soft tissues), biological fluids (synovial, pericardial, pleural, sputum, bile, urine, cerebrospinal fluid). Penetrates through the placental barrier. The volume of distribution is 0.24±0.03 l/kg.

30% of the drug is metabolized in the liver. The metabolite desacetylcefotaxime has pronounced antimicrobial activity. It is excreted unchanged by the kidneys (20-36%), the rest in the form of metabolites. When administered intramuscularly, the elimination half-life (T½) is 1.0-1.5 hours, and when administered intravenously, it is about 1 hour.

At renal failure, as well as in persons over 80 years of age, the half-life of elimination increases to 2.5 hours. In children over 1 month of age, T½ is 1.4-6.4 hours, in newborns T½ is 0.75-1.5 hours, in premature infants weighing less than 1500 g increases to 4.6 hours, more than 1500 g - 3.4 hours.

Pharmacodynamics

Cephalosporin antibiotic III generation wide spectrum of action. It has a bactericidal effect, inhibiting the synthesis of the cell wall of microorganisms. Resistant to β-lactamases of gram-positive and game-negative bacteria.

Active against gram-positive aerobic bacteria: Bacillus subtilis, Enterococcus spp., Corynebacterium diphtheriae, Erysipelothrix insidiosa, Propionibacterium spp., Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus viridans Streptococcus bovis; gram-negative aerobic bacteria: Aeromonas hydrophila, Bordetella pertussis, Borrelia burgdorferi, Enterobacter aerogenes, Enterobactercloacae, Escherichia coli, Eubacterium spp., Haemophilus ducreyi, Haemophilus influenzae (including penicillinase-producing strains), Haemophilus parainfluenzae, Klebsiella spp. (including Klebsiella pneumoniae, Klebsiella oxytoca), Moraxella catarrhalis (including β-lactamase-producing strains), Morganella morganii, Neisseria gonorrhoeae (including penicillinase-producing strains), Neisseria meningitides, Proteus mirabilis, Proteus vulgaris, Providencia spp., Salmonella spp. (including Salmonella typhi), Serratiaspp. (including Serratia marsescens), Shigella spp., Veilonella spp., Yersinia spp.; gram-negative anaerobic bacteria: Clostridium spp. (except Clostridium difficile).

Acinetobacter baumanii, Bacteroides strains producing β-lactamases, Clostridium difficile, and methicillin-resistant Staphylococcus spp. are resistant to cefotaxime. and Enterococcus spp., Listeria monocytogenes, Pseudomonasaeruginosa and Pseudomonas cepacea, Stenotrophomonas maltophilia, gram-negative anaerobes Fusobacterium spp. Peptococcus spp., Peptostreptococcus spp.

Penicillins and cephalosporins of I-II generations do not form cross-resistance to cefotaxime.

Indications for use

hospital (nosocomial) and severe community-acquired infections of the upper and lower sections respiratory tract and ENT organs (bronchitis, pneumonia, lung abscesses, pleural empyema, acute otitis media)

spicy and chronic infections genitourinary system (pyelitis, pyelonephritis, cystitis, endometritis, adnexitis)

acute uncomplicated gonorrhea

intra-abdominal infections (including peritonitis)

Lyme disease

central nervous system infections (including meningitis, with the exception of listeria)

septicemia, bacteremia

infections of the skin and soft tissues (pyoderma, sycosis, abscesses, carbuncles, phlegmons, infected wounds and burns)

infections of bones and joints (arthritis, osteomyelitis)

prevention of infections after surgical interventions urological, obstetric and gynecological hospitals, during bowel operations.

Use strictly as prescribed by your doctor!

Directions for use and doses

The drug is administered intramuscularly or intravenously. The dosage, route of administration and interval between administrations depend on the severity of the infection, the sensitivity of the microorganism that caused the disease and the condition of the patient. The recommended course of treatment is 7 days.

For acute uncomplicated gonorrhea, 0.5-1.0 g is administered intramuscularly once.

For adults with moderate infections, it is administered intramuscularly or intravenously in a single dose of 1.0-2.0 g with an interval of 8-12 hours, the daily dose is 2.0-6.0 g. For severe infections, it is administered intravenously in a single dose of 2.0 g with the interval between injections is 6-8 hours, the daily dose is 6.0-8.0 g (maximum - up to 12.0 g/day).

In persons with impaired renal function with creatinine clearance less than 10 ml/min, the single and daily dose is reduced by 2 times, the interval between administration is not changed. In patients undergoing hemodialysis, cefotaxime is administered at a dose of 1.0-2.0 g/day. On the day of dialysis, cefotaxime is administered immediately after the procedure.

For premature infants up to 1 week of life, cefotaxime is administered at a daily dose of 50-100 mg/kg intravenously in 2 injections with an interval of 12 hours. For infants 1-4 weeks of age, cefotaxime is administered at a dose of 75-150 mg/kg/day intravenously in 3 injections with an interval of 8 hours

For children weighing up to 50 kg, the daily dose of cefotaxime is 50-100 mg/kg, administered intravenously or intramuscularly in equal doses at intervals of 6-8 hours. The daily dose should not exceed 2.0 g (for severe infections and meningitis - no more than 4.0 g/ days).

For children weighing 50 kg or more, cefotaxime is prescribed in the same dose as for adults.

To prevent postoperative infections, cefotaxime is administered once during induction anesthesia in a dose of 1.0 g. If necessary, the administration is repeated after 6-12 hours. At caesarean section administered intravenously at a dose of 1.0 g at the moment the clamp is applied to the umbilical cord and then again 6 and 12 hours after the first injection.

For intramuscular injections 1.0 g of the drug is dissolved in 4 ml of water for injection or 1% lidocaine solution; for 2.0 g of the drug, 10 ml of solvent is used. After dissolution, the drug should be used within 8 hours.

For intravenous administration, 1.0-2.0 g of the drug is diluted with 50-100 ml of sterile water for injection, 5% glucose solution, Ringer's solution, 0.9% sodium chloride solution. During dilution, the bottles are shaken vigorously until completely dissolved. Before using frozen solvent solutions, they should be thawed at room temperature (heating the solutions is not allowed). The infusion is carried out slowly, over 30-60 minutes.

Side effects

anaphylactic shock, angioedema, bronchospasm

urticaria, erythema, fever, ecfoliative dermatitis, Stevens-Johnson syndrome, Lyell's syndrome

nausea, vomiting, abdominal pain, diarrhea, increased activity of transaminases, LDH, γ-GGT, alkaline phosphatase or bilirubin

increased creatinine concentration, interstitial nephritis

neutropenia, rarely - agranulocytosis, eosinophilia, thrombocytopenia, hemolytic anemia

encephalopathy (high doses in patients with renal failure)

arrhythmias with rapid insertion through a central venous catheter

with intramuscular injection - pain at the injection site, with intravenous administration- phlebitis

superinfections (including oral candidiasis and vaginal candidiasis)

Contraindications

hypersensitivity to cefotaxime and other β-lactam antibiotics (including penicillins, cephalosporins, carbapenems)), lidocaine (solvent for intramuscular administration)

hemorrhagic syndrome or enterocolitis (especially nonspecific ulcerative colitis) in history

pregnancy and lactation (cessation of breastfeeding is mandatory)

children up to 2.5 years of age (for intramuscular administration).

Drug interactions

It has synergism with aminoglycosides against gram-negative flora.

Lincosamides, sulfonamides, tetracyclines, chloramphenicol for simultaneous use with cefotaxime mutually weaken the antimicrobial effect of each other.

When used simultaneously with nephrotoxic drugs (aminoglycosides, furosemide), it increases the risk of kidney damage. When used together with NSAIDs, antiplatelet agents, anticoagulants, the likelihood of bleeding increases.

Solutions of cefotaxime are pharmaceutically incompatible with other antibiotics, as well as with solutions containing calcium ions. When used together with non-steroidal anti-inflammatory drugs, loop diuretics, probenecid, allopurinol, the concentration of cefotaxime in plasma increases and the risk of developing toxic reactions increases.

special instructions

In case of renal failure, dose adjustment is required taking into account cratinine clearance (dose reduction by 2 times if creatinine clearance is less than 10 ml/min) and monitoring of drug concentration in plasma.

When treating patients with meningitis and sepsis, massive intravascular bacteriolysis with the formation of acute adrenal insufficiency is possible; in this case, it may be necessary to prescribe injectable corticosteroids and sympathomimetic drugs.

Caution when using. Lidocaine as a solvent is not recommended for use by persons with intracardiac blockade without an established pacemaker, severe heart failure, or hypersensitivity to lidocaine. In the first weeks, pseudomembranous colitis may develop, manifested by severe and long-term diarrhea. Caution should be exercised when prescribing the drug to patients with allergic reactions to penicillins.

If long-term administration of cefotaxime is necessary, indicators should be monitored at least once every 5-7 days. peripheral blood, functional tests of the liver and kidneys.

Influence at laboratory parameters. When treated with cefotaxime, there may be false positives when determining glucose in urine using Benedict's solution, Fechtling's solution or Clinitest tablets. False-positive Coombs test results may occur.

Use in pediatrics. In children under 2.5 years of age, the use of cefotaxime diluted with lidocaine is unacceptable.

Features of the effect of the drug on the ability to drive vehicle or potentially dangerous mechanisms. Caution should be exercised when operating a vehicle or potentially dangerous machinery.

Overdose

When high doses are administered to patients with impaired renal function, neurotoxic reactions may occur in the form of encephalopathy: dizziness, tremor, convulsions, increased neuromuscular excitability, impaired consciousness.