biotic therapy.
For disseminated gonococcal infection† (e.g., sepsis, arthritis, meningitis) and scalp abscesses† in neonates.
Intravenous and Intramuscular dosage
Neonates
25 mg/kg/dose IV or IM every 12 hours for 7 days, or for 10 to 14 days for meningitis, is recommended by the Centers for Disease Control (CDC) and American Academy of Pediatrics (AAP) as an alternative to ceftriaxone, particularly in neonates with hyperbilirubinemia.
For surgical infection prophylaxis.
Intravenous and Intramuscular dosage
Adults
1 g IV or IM as a single dose within 30 to 90 minutes prior to the surgical incision. For cesarean section, 1 g IV or IM as soon as the umbilical cord is clamped, then 1 g IV or IM every 6 hours for 2 more doses. Clinical practice guidelines suggest 1 g IV, or for obese patients, 2 g IV within 60 minutes prior to the surgical incision. Intraoperative redosing 3 hours from the first preoperative dose and duration of prophylaxis less than 24 hours are suggested by clinical practice guidelines. Cefotaxime is FDA-approved for surgical procedures that may be classified as contaminated or potentially contaminated (i.e., abdominal or vaginal hysterectomy, gastrointestinal and genitourinary tract surgery). However, clinical practice guidelines recommend cefotaxime only in combination with ampicillin for liver transplantation.
Infants†, Children†, and Adolescents† undergoing liver transplantation
50 mg/kg IV or IM as a single dose (Max: 1 g/dose; 2 g/dose in obese patients) within 60 minutes prior to the surgical incision, in combination with ampicillin. Repeat dose intraoperatively 3 hours after preoperative dose if surgery still in progress. The duration should not exceed 24 hours.
For the treatment of lower respiratory tract infections, including pneumonia and community-acquired pneumonia (CAP).
Intravenous or Intramuscular dosage
Adults
For uncomplicated infections: 1 g IV or IM every 12 hours. For moderate to severe infections: 1 to 2 g IV or IM every 8 hours. For severe infections: 2 g IV every 6 to 8 hours. And, for life-threatening infections: 2 g IV every 4 hours. The maximum dosage is 12 g/day. For inpatient, non-ICU patients with community-acquired pneumonia, use in combination with a macrolide antibiotic (azithromycin, clarithromycin, or erythromycin) or with doxycycline. For ICU patients, give in combination with azithromycin or a respiratory quinolone (levofloxacin, moxifloxacin). Add vancomycin or linezolid if MRSA is a potential pathogen. The IDSA/ATS recommend treatment for a minimum of 5 days and the patient should be afebrile for 48 to 72 hours with no more than 1 sign of clinical instability before discontinuation.
Children and Adolescents 50 kg or more
For uncomplicated infections: 1 g IV or IM every 12 hours. For moderate to severe infections: 1 to 2 g IV or IM every 8 hours. For severe infections: 2 g IV every 6 to 8 hours. And, for life-threatening infections: 2 g IV every 4 hours. The maximum dosage is 12 g/day. For community-acquired pneumonia, 2 g IV every 8 hours for 10 days is recommended by the Infectious Diseases Society of America (IDSA). The IDSA recommends cefotaxime as empiric therapy in hospitalized pediatric patients who are not fully immunized, have life-threatening infections including empyema, and in regions with high levels of penicillin resistant pneumococcal strains. Consideration of combination therapy with a macrolide for suspected atypical pneumonia or with cl |
