GEBETAX 500MG INJECTION

Indications

• Bacterial meningitis
• Severe pneumonia
• Urinary tract infections
• Sepsis
• Skin and soft tissue infections
• Intra-abdominal infections

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing guidelines based on age, weight, and clinical condition.

Adults: Refer to the BNF for specific dosage recommendations, which may vary based on the type and severity of the infection.

Mechanism of action

Cefotaxime exerts its antibacterial effect by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, disrupting the transpeptidation process, which is crucial for cell wall structural integrity. This inhibition leads to the lysis and death of the bacteria.

Pharmacodynamics

Cefotaxime demonstrates time-dependent antibacterial activity, meaning that the duration for which the drug concentration remains above the minimum inhibitory concentration (MIC) is critical for its effectiveness. It has a broad spectrum of activity, particularly against Enterobacteriaceae, Streptococcus pneumoniae, and Haemophilus influenzae.

Pharmacokinetics

Cefotaxime is administered parenterally and is rapidly distributed throughout the body, achieving high concentrations in tissues and body fluids. It is primarily eliminated by renal excretion, with about 50-70% of the drug being excreted unchanged in the urine. The half-life is approximately 1 hour in individuals with normal renal function, but it may be prolonged in those with renal impairment.

Contra-indications

• Hypersensitivity to cefotaxime or any cephalosporin antibiotics
• History of severe allergic reactions to penicillins
• Severe renal impairment (without dose adjustment)

Adverse effects

• Diarrhea
• Nausea
• Vomiting
• Rash
• Allergic reactions (e.g., anaphylaxis)
• Neutropenia
• Thrombocytopenia
• Elevated liver enzymes
• Seizures (in cases of overdose or renal impairment)

Interactions

• Probenecid may increase serum concentrations of cefotaxime
• Aminoglycosides may have additive nephrotoxicity
• Oral anticoagulants may have altered effects due to changes in gut flora
• Cephalosporins may interfere with the effectiveness of live bacterial vaccines

Precautions

• Use with caution in patients with a history of gastrointestinal disease, particularly colitis
• Monitor renal function in patients with pre-existing renal impairment
• Caution in patients with a history of penicillin allergy
• May cause false-positive results in urinary glucose tests

Pregnancy

Cefotaxime is categorized as pregnancy category B. It should only be used if clearly needed and the benefits outweigh the risks.

Breast-feeding

Cefotaxime is excreted in breast milk in small amounts. Caution is advised when administering to nursing mothers.

Storage

Store at 2-8 degrees Celsius. Protect from light. Reconstituted solutions should be used promptly or stored at 2-8 degrees Celsius for no more than 24 hours.

Formulations

• Injection: Cefotaxime sodium for injection in various strengths (e.g., 500 mg, 1 g, 2 g)