Cefotaxime
Cefotaxime is an injectable third-generation cephalosporin used for serious infections caused by susceptible bacteria. Its broad gram-negative activity and distribution into several body compartments support use in hospitalized veterinary patients, including neonates. It retains activity against some gram-positive organisms and has an active metabolite, desacetylcefotaxime.
Group
Third-generation cephalosporin
Mechanism of Action
Cefotaxime binds bacterial penicillin-binding proteins and inhibits peptidoglycan cross-linking, weakening the cell wall and causing bactericidal effects in growing bacteria. Its third-generation structure extends activity against many susceptible gram-negative bacilli. Desacetylcefotaxime contributes additional antibacterial activity. Clinical effect is time dependent and reflects exposure above the organism’s minimum inhibitory concentration.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bacterial infections | 25 mg/kg | IV, IM, SC | Every 8 h | |
| Antibacterial infusion — Loading | 3.2 mg/kg | IV | Once | |
| Antibacterial infusion — Maintenance | 5 mg/kg/hour | IV | Continuous | |
| Bacterial infections | 25–50 mg/kg | IV, IM, SC | Every 8 h | |
| Sepsis | 20–80 mg/kg | IV, IM | Every 8 h | |
| Central nervous system infection | 25–50 mg/kg | IV, IM | Every 8 h | |
| Soft-tissue infection | 22 mg/kg | IV, IM, SC | Every 8 h | Up to 7 days |
| Soft-tissue infection | 50 mg/kg | IV, IM | Every 12 h | Up to 7 days |
| Orthopedic infection | 20–40 mg/kg | IV, IM, SC | Every 6–8 h | Up to 7 days |
| Severe bacteremia | 20–80 mg/kg | IV | Every 6 h | |
| Severe bacteremia | 10–50 mg/kg | IV | Every 4–6 h |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bacterial infections | 25 mg/kg | IV, IM, SC | Every 8 h | |
| Bacterial infections | 25–50 mg/kg | IV, IM, SC | Every 8 h | |
| Sepsis | 20–80 mg/kg | IV, IM | Every 8 h | |
| Central nervous system infection | 25–50 mg/kg | IV, IM | Every 8 h | |
| Severe bacteremia | 20–80 mg/kg | IV, IM | Every 6 h | |
| Historical pancreatitis prophylaxis | Reference only | IM | The older source lists 50 mg/kg IM every eight hours to prevent pancreatic colonization. Current feline pancreatitis consensus does not recommend antibiotics for uncomplicated sterile pancreatitis; use only for a separate suspected or confirmed bacterial indication. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bacterial infections | 25 mg/kg | IV | Every 6 h | |
| Bacterial infections | 40 mg/kg | IV | Every 6 h | Foals only. Give bolus over one minute. |
| Antibacterial infusion — Loading | 4 mg/kg | IV | Once | Foals only. |
| Antibacterial infusion — Maintenance | 2.5 mg/kg/hour | IV | Continuous | Foals only. |
| Foal meningitis | 40 mg/kg | IV | Every 6–8 h | Foals only. |
| Foal systemic infection | 20–30 mg/kg | IV, IM | Every 6–8 h | Foals only. |
| Regional limb perfusion for septic arthritis | Reference only | IV | Foals: 1 g cefotaxime in 20 mL saline, with tourniquets above and below the joint; leave tourniquets in place 20 minutes. This is a regional perfusion procedure, not systemic IV dosing. |
Birds
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bacterial infections | 50–100 mg/kg | IM | Every 8 h | If combined with an aminoglycoside, assess nephrotoxicity risk. |
| Bacterial infection or hepatitis | 75–100 mg/kg | IM, IV | Every 4–8 h |
Ratites
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bacterial infections | 25 mg/kg | IM | Every 8 h | Young ratites. |
Indications
- Parenteral treatment of serious susceptible bacterial infections in dogs and cats, including bacteremia, sepsis and severe respiratory or urinary tract infection.
- Treatment of selected neonatal bacterial infections, including sepsis in foals, when the organism is susceptible.
- Treatment of selected bacterial central nervous system infections when susceptibility and achievable cerebrospinal fluid exposure support cefotaxime use.
Contraindications
- Cephalosporin hypersensitivity; assess prior severe beta-lactam allergy.
Interactions
- Avoid mixing with other drugs in the same vial or syringe unless compatibility is established.
Adverse effects
- Hypersensitivity
- Gastrointestinal upset
- Injection-site reactions with parenteral products
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Cefotaxime 500 mg vial Strength is per vial; no final mL concentration is implied. | Injection | 500 mg / vial | IV, IM, SC |
| Cefotaxime 1000 mg vial Strength is per vial; no final mL concentration is implied. | Injection | 1000 mg / vial | IV, IM, SC |
| Cefotaxime 2000 mg vial Strength is per vial; no final mL concentration is implied. | Injection | 2000 mg / vial | IV, IM, SC |
| Cefotaxime 10000 mg vial Strength is per vial; no final mL concentration is implied. | Injection | 10000 mg / vial | IV, IM, SC |
Monitoring and Administration
Choose treatment using organism identity, infection site and susceptibility testing. Reassess clinical response and renal function where impaired clearance may increase exposure.
Food-animal authorization and withdrawal periods depend on the exact formulation, species, regimen and jurisdiction; do not transfer foreign approvals or residue intervals to another product.
Avoid alkaline solutions. Reconstituted vials are described as stable 12 hours at room temperature or 5 days refrigerated; dilute IV fluids for 24 hours at room temperature or 5 days refrigerated. Frozen stability of 13 weeks is described. Do not refreeze. Mild yellow or amber color alone does not establish loss of potency.
Do not use cefotaxime in sodium bicarbonate or another solution above pH 7.5. Assess renal function in patients with impaired clearance.
Antibiotics are not routine therapy for uncomplicated pancreatitis; a separate bacterial infection or strong evidence of sepsis is needed.