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Cefotetan disodium
Cefotetan disodium (Cefotan)
Cefotetan disodium
(sef-oh-TEE-tan)
Pregnancy Category: B Cefotan (Rx)

Classification: Cephalosporin, second-generation

See Also: See also Anti-Infectives and Cephalosporins.

Action/Kinetics: t1/2: 3-4.6 hr. Peak serum levels after 1 g IV: 158 mcg/mL. From 50% to 80% is excreted unchanged in the urine.

Uses: (1) Urinary tract infections due to Escherichia coli, Klebsiella species, Proteus vulgaris, Providencia rettgeri, and Morganella morganii. (2) Lower respiratory tract infections due to Streptococcus pneumoniae, Staphylococcus aureus, H. influenzae (including ampicillin-resistant strains), Klebsiella species, Proteus mirabilis, Serratia marcescens, and E. coli. (3) Skin and skin structure infections due to S. aureus, S. epidermidis, S. pyogenes, Streptococcus species (excluding enterococci), Klebsiella pneumonia, Peptococcus niger, Peptostreptococcus species, and E. coli. (4) Gynecologic infections due to S. aureus, S. epidermidis, Streptococcus species (excluding enterococcus), S. agalactiae, E. coli, P. mirabilis, N. gonorrhoeae, Bacteroides species (excluding B. distasonis, B. ovatus, B. thetaiotaomicron), Fusobacterium species and gram-positive anaeroabic cocci (including Peptococcus and Peptostreptococcus species). (5) Intra-abdominal infections due to E. coli, Klebsiella species (including K. pneumoniae), Streptococcus species (excluding enterococci), Bacteroides species (excluding B. distasonis, B. ovatus, B. thetaiotaomicron), and Clostridium species. (6) Bone and joint infections due to S. aureus. (7) Perioperatively to prevent infections in those underoing cesarian section, abdominal or vaginal hysterectomy, transurethral surgery, or GI and biliary tract surgery.
The IV route is preferred with bacterial septicemia, bacteremia, or other severe or life-threatening infections. It's also preferred for poor-risk clients as the result of malnutrition, surgery, diabetes, trauma, heart failure, malignancy, or if shock is present or impending.

Special Concerns: Safety and effectiveness have not been determined in children.

Additional Side Effects: Concomitant use with ethanol produces a disulfiram-type reaction and hypotension.

Additional Laboratory Test Interferences: May affect measurement of creatinine levels by the Jaffe reaction.

How Supplied: Injection: 1 g/50 mL, 2 g/50 mL; Powder for injection: 1 g, 2 g, 10 g

Dosage
•IV or IM Mild to moderate skin/skin structure infections.
Adults: 2 g q 24 hr IV or 1 g q 12 hr IV or IM. Klebseilla pneumoniae skin/skin structure infections: 1 or 2 g q 12 hr IV or IM.
Severe skin/skin structure infections.
Adults, IV: 2 g q 12 hr.
UTIs.
Adults: Either 0.5 g q 12 hr IV or IM, 1 or 2 g q 24 hr IV or IM, or 1 or 2 g q 12 hr IV or IM.
Infections of other sites.
Adults: 1 or 2 g q 12 hr IV or IM.
Severe infections.
Adults, IV: 2 g q 12 hr.
Life-threatening infections.
Adults, IV: 3 g q 12 hr.
Prophylaxis of postoperative infection.
Adults, IV: 1-2 g 30-60 min prior to surgery.
Use in impaired renal function.
May maintain q 12 hr dosing but reduce dose by 1/2 if the C_CR is 10-30 mL/min and reduce the dose by 1/4 if the C_CR is less than 10 mL/min. If only serum creatinine is available, use the following formulas to calculate the C_CR:
Males: Weight (kg) x (140-age) / 72 x serum creatinine (mg/dL).
Females: 0.85 x above value.