cefotetan (Cefotan)
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Introduction
Tradename: Cefotan. 2nd generation cephalosporin.
Indications
- treatment of moderate to serious mixed anaerobic & aerobic infections
- prophylaxis for perioperative infection[6] Contraindiactions:
Dosage
Dosage adjustment in renal failure
Table
| creatinine clearance | dose |
|---|---|
| > 30 mL/min | 1-2 g IV every 12 hours |
| 10-29 mL/min | 1-2 g IV every 24 hours |
| < 9 mL/min | 0.5-1 g IV every 24 hours |
| 1 g IV after hemodialysis |
Pharmacokinetics
- eliminated unchanged in the urine
- distributed well to most tissues & body fluids
- poor CSF penetration
- 1/2life 3.5 hours (13-25 hours ESRD)
elimination via kidney
1/2life = 3.5 hours
protein binding = 76-90 %
Antimicrobial activity
- Neisseria gonorrhoeae
- Neisseria meningitidis
- Moraxella catarrhalis
- Haemophilus influenzae
- Escherichia coli
- Klebsiella species
- Enterobacter species (+/-)
- Serratia species
- Salmonella species
- Shigella species
- Proteus mirabilis
- Proteus vulgaris
- Providencia species
- Morganella species
- Citrobacter species (+/-)
- Aeromonas species
- Yersinia enterocolitica (+/-)
- Bacteroides fragilis (+/-)
- Bacteroides melaninogenicus
- Clostridium difficile
- Clostridium species
- Peptostreptococcus species
- Fusobacterium[6]
Adverse effects
- bleeding secondary to coagulopathy (in elderly)
- check PT before & during therapy
- consider alternate pharmaceutical if coagulopathy
- increased liver function test
- hemolytic anemia (may be fatal)
- hypersensitivity reactions
- headache
Drug interactions
- coadministration with alcohol may produce a disulfiram-like reaction
- cefotetan may enhance the effect of warfarin & heparin
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) of antibiotics with warfarin
Mechanism of action
inhibition of bacterial cell wall synthesis
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 162
- ↑ Sanford Guide to antimicrobial therapy 1997
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ 5.0 5.1 Geriatric Dosage Handbook, 6th edition, Selma et al eds, Lexi-Comp, Cleveland, 2001
- ↑ 6.0 6.1 6.2 6.3 Deprecated Reference
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=50614
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=441198
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=53024
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=53025
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=475320
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2633
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2634