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Treatment of infections of lower respiratory tract including pneumonia, urinary tract, skin and skin structures, bone and joints; treatment of bacteremia/septicemia, CNS infections, intra-abdominal infections including peritonitis, gynecological infections including pelvic inflammatory disease, endometritis and pelvic cellulitis caused by susceptible strains of specific microorganisms; perioperative prophylaxis.


Hypersensitivity to cephalosporins.

Adverse reactions:

GI Colitis, diarrhea, nausea, vomiting (at least 1%); pseudomembranous colitis symptoms can occur during or after treatment. Hypersensitivity Rash, pruritus, fever, eosinophilia, urticaria, anaphylaxis (at least 1%). Local Injection-site inflammation with IV administration; pain and induration, tenderness after IM administration (at least 1%).


Aminoglycosides Increased risk of nephrotoxicity. Incompatibility Do not add aminoglycosides to cefotaxime solutions because inactivation of both drugs may result; administer at separate sites if concurrent therapy is indicated. Laboratory Test Interactions False-positive direct Coombs test results in certain patients (eg, those with azotemia).


Monitor Review results of culture and sensitivity testing as appropriate. Ensure that cefotaxime is discontinued and another antimicrobial agent is started if sensitivity tests indicate that the organism is resistant to cefotaxime. Pregnancy Category B . Lactation Excreted in breast milk. Elderly Because elderly patients are more likely to have decreased renal function, use care in dose selection and consider monitoring renal function. Hypersensitivity Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity. Renal Function Use with caution. Reduce dose when Ccr is less than 20 mL/min. Superinfection May result in bacterial or fungal overgrowth of nonsusceptible microorganisms. GI disease Use with caution, especially in patients with history of colitis. Granulocytopenia Granulocytopenia, and more rarely, agranulocytosis, may develop during treatment with cefotaxime, particularly if given over long periods. Monitor CBC during course of treatment lasting longer than 10 days. Local irritation May be locally irritating to tissues in the event of extravasation. Regularly monitor infusion sites and change when appropriate. Pseudomembranous colitis Consider in patients in whom diarrhea develops.



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