What is the dose of Cefotax (Cefotaxime), a third-generation cephalosporin (Cephalosporin) antibiotic?

From the Guidelines

Cefotaxime is typically dosed at 1-2 grams intravenously every 8-12 hours for most adult infections, with adjustments needed for renal impairment, as recommended by the most recent and highest quality study 1.

Key Considerations

• For severe infections or meningitis, higher doses of 2 grams every 4-6 hours may be required, up to a maximum of 12 grams daily.
• Pediatric dosing is usually 50-200 mg/kg/day divided into 3-4 doses, depending on the severity of infection and the child's age, as seen in the guidelines for community-acquired bacterial meningitis 1.
• Neonates require lower doses, typically 50 mg/kg every 8-12 hours.

Important Details

• Treatment duration generally ranges from 5-14 days based on the infection type and clinical response.
• Cefotaxime is a third-generation cephalosporin antibiotic that works by inhibiting bacterial cell wall synthesis, making it effective against many gram-negative and some gram-positive bacteria.
• It has good penetration into cerebrospinal fluid, making it valuable for treating meningitis, as noted in the guidelines for community-acquired bacterial meningitis 1.

Side Effects and Precautions

• Common side effects include injection site reactions, gastrointestinal disturbances, and potential for hypersensitivity reactions in patients with penicillin allergies.
• The guidelines for infective endocarditis in childhood also recommend cefotaxime as an option for treating gram-negative enteric bacilli, with a dose of 200 mg/kg/day divided every 6 hours up to 12 g daily 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Adults Dosage and route of administration should be determined by susceptibility of the causative organisms, severity of the infection, and the condition of the patient (see table for dosage guideline). The maximum daily dosage should not exceed 12 grams GUIDELINES FOR DOSAGE OF CEFOTAXIME FOR INJECTION Type of InfectionDaily Dose (grams)Frequency and Route Gonococcal urethritis/cervicitis in males and females0.50.5 gram IM (single dose) Rectal gonorrhea in females0.50. 5 gram IM (single dose) Rectal gonorrhea in males11 gram IM (single dose) Uncomplicated infections21 gram every 12 hours IM or IV Moderate to severe infections3-61-2 grams every 8 hours IM or IV Infections commonly needing antibiotics in higher dosage (e.g., septicemia)6-82 grams every 6-8 hours IV Life-threatening infectionsup to 122 grams every 4 hours IV

The dose of Cefotax (Cefotaxime) varies based on the type of infection and patient condition. The recommended daily doses are:

• Uncomplicated infections: 1-2 grams every 12 hours IM or IV
• Moderate to severe infections: 3-6 grams every 8 hours IM or IV
• Infections needing higher dosage: 6-8 grams every 6-8 hours IV
• Life-threatening infections: up to 12 grams every 4 hours IV The maximum daily dosage should not exceed 12 grams 2.

From the Research

Cefotaxime Dosage

The dosage of Cefotaxime, a third-generation cephalosporin antibiotic, can vary depending on the severity of the infection and the patient's condition.

• The recommended dosage regimens for Cefotaxime include:
  • 0.5 to 2.0 gm administered from two to six times a day 3
  • 1 g every 8 hours or every 12 hours for highly susceptible pathogens 3, 4
  • 1 g every 6 or 8 hours for adult patients 5
  • 50 mg/kg every six to eight hours for pediatric patients with a body weight greater than 20 kg, which can be limited to a standard 1-gram dose for mild to moderate infections 6
  • 75 mg/kg every 8 h or every 12 h for infants and children 7

Factors Affecting Dosage

The dosage of Cefotaxime can be affected by several factors, including:

• The severity of the infection
• The type of microorganism causing the infection
• The patient's weight and age
• The presence of any underlying medical conditions
• The need for high local drug concentrations, such as in meningitis and endocarditis 5

Clinical Efficacy

Cefotaxime has been shown to be effective in a wide range of dosage schedules, with uniformly good clinical and bacteriological success rates achieved in all dosage regimens 3, 4, 5.

• The results of various clinical studies suggest that Cefotaxime doses as low as 1 g, at intervals as long as every 12 h, can be adequate for treatment of commonly encountered infections 4
• The time above the MIC90 for pediatric patients was equivalent to or exceeded those of the adult simulations for all pathogens 6