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← New search | Cefotaxime / Sulbactum

INN monograph

Cefotaxime / Sulbactum

Beta-lactam antibiotic — cephalosporin · POM

POM Source-linked Grade A-

Source-linked · Updated 03 Aug 2026 · Source: Local active-ingredient clinical extract; FDA drug label via OpenFDA/DailyMed; Component monographs (multi-source pipeline); Professional class pharmacology (Beta-lactam antibiotic — cephalosporin)

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Risk first

Contraindications

  • Serious hypersensitivity to cephalosporins.
  • Use extreme caution or avoid if prior anaphylaxis to penicillins (cross-reactivity lower than historically feared but not zero, especially similar side chains).

Precautions

  • Allergy history.
  • Superinfection / C. difficile risk.
  • Adjust renally cleared agents for CrCl.
  • Ceftriaxone: avoid concurrent IV calcium in neonates
  • biliary sludge with prolonged use.

Point of care

Dosing

Adult

Dosing is indication-, age-, weight- and organ-function-specific for this INN. Do not use class averages for high-risk patients. Confirm the exact regimen in the current SmPC and Kenya Standard Treatment Guidelines. Typical professional workflow: (1) confirm indication, (2) check renal/hepatic function, (3) screen interactions/allergies, (4) select dose/route/duration, (5) define monitoring.

Paediatric

Paediatric dosing is weight- and age-based; use a paediatric formulary / SmPC. Do not extrapolate adult tablets without calculation.

Renal

Most require dose adjustment in renal impairment (exceptions/nuances per agent — check SmPC).

  • CrCl 0–120: Confirm renal dosing in product SmPC / primary label.

Hepatic

Usually low; transient LFT elevations possible.

Safety

Drug interactions

Open checker →
  • Choose generation by indication and resistance patterns.
  • Prefer narrowest effective spectrum.
  • IV-to-oral switch when clinically stable.
  • Align duration with guidelines (often shorter than historical practice for many infections).

Safety

Adverse effects

  • GI disturbances, allergic reactions, blood dyscrasia, severe headaches, glossitis, pain at I.M injection site, pseudomembranous entero-colitis, oedema, genital tract mycosis, oliguria.

Use

Indications

  • Septicaemia, meningitis in neonates and infants, peri-operative infections prophylaxis, UTI, RTI, bone, joints, skin and soft tissue infections.
  • Clinical selection for Cefotaxime / Sulbactum should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
  • Class context: Beta-lactam antibiotic — cephalosporin.
  • Confirm site-specific dose, duration and monitoring before prescribing.

Pharmacology

Mode of action

Cefotaxime interferes with the synthesis of peptidoglycans, which are part of bacterial cell wall [bactericidal].

Bind PBPs Block wall cross-linking Osmotic lysis Bactericidal
Full mechanism text

Cefotaxime interferes with the synthesis of peptidoglycans, which are part of bacterial cell wall [bactericidal]. Sulbactam is a beta-lactamase inhibitor. Cephalosporins inhibit bacterial cell-wall synthesis by binding PBPs and blocking peptidoglycan cross-linking, producing bactericidal activity against susceptible organisms. Spectrum broadens from 1st to later generations; stability to beta-lactamases varies.

ADME

Pharmacokinetics & PD

Onset Rapid (IV); 1–2 h oral
Duration 6–24 hours (agent-dependent; ceftriaxone long)
Route INTRAMUSCULAR, INTRAVENOUS
Distribution into tissues good; CSF penetration generation- and inflammation-dependent (e.g. ceftriaxone/cefotaxime used in meningitis). Many cleared renally; ceftriaxone has dual renal/biliary
Elimination — caution in neonates with hyperbilirubinaemia.
Full PK/PD text

Oral agents have variable bioavailability; parenteral agents achieve high peak levels. Distribution into tissues good; CSF penetration generation- and inflammation-dependent (e.g. ceftriaxone/cefotaxime used in meningitis). Many cleared renally; ceftriaxone has dual renal/biliary elimination — caution in neonates with hyperbilirubinaemia.

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Special populations

Pregnancy & lactation

Pregnancy

Generally considered acceptable in pregnancy when indicated; prefer agents with established safety data.

Lactation

Usually compatible; monitor infant for GI effects.

Diet

Food & alcohol

  • Food
  • Food

Trust

Sources & disclaimer

Source: Local active-ingredient clinical extract; FDA drug label via OpenFDA/DailyMed; Component monographs (multi-source pipeline); Professional class pharmacology (Beta-lactam antibiotic — cephalosporin)

Open source link

Clinical review date not recorded.

Decision support only — not a substitute for clinical judgment, product SmPC, or Kenya STG/EML.

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