Cefotetan
Cefotetan disodium
Also known as: Cefotan · Apacef · Apatef · Ceftenon · Cepan · Darvilen · Yamatetan · ICI-156834 · YM-09330
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Susceptible infections | 30 mg/kg SC q12h | SC | q12h | — | 🌎 NA |
| Soft tissue infections | 30 mg/kg SC q12h | SC | q12h | 7 days or less | 🌎 NA |
| Bacteremia, sepsis | 30 mg/kg IV, SC q8h | IV, SC | q8h | as long as required | 🌎 NA |
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Sepsis | 30 mg/kg q5-8h IV | IV | q5-8h | — | 🌎 NA |
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Cefotetan is a 2nd-generation cephalosporin (specifically a cephamycin) with an extended spectrum of activity against anaerobic bacteria (such as Bacteroides spp.) and enteric Gram-negative rods (such as E. coli).
It is structurally and pharmacologically similar to cefoxitin but boasts a more favorable pharmacokinetic profile, allowing for less frequent dosing intervals in small animals.
Clinical Pearls:
- Cefotetan contains an N-methylthiotetrazole (NMTT) side chain (similar to cefoperazone). This specific structural feature can interfere with vitamin K metabolism, potentially leading to hypoprothrombinemia (bleeding tendencies), and can cause disulfiram-like reactions if exposed to alcohol.
- It is highly effective against many anaerobes and is often utilized for serious soft tissue infections, sepsis, or intra-abdominal infections.
Mechanism of action
Cefotetan is a bactericidal time-dependent antibiotic.
- It binds to specific Penicillin-Binding Proteins (PBPs) located inside the bacterial cell wall.
- Binding → inhibition of the third and final stage of bacterial cell wall synthesis (mucopeptide/peptidoglycan cross-linking).
- This leads to weakened cell walls → cell lysis and death mediated by bacterial autolysins.
- As a cephamycin, it is highly resistant to degradation by many beta-lactamases produced by Gram-negative and anaerobic bacteria.
Safety & warnings
Contraindications
- Known hypersensitivity to cephamycins or cephalosporins
- Caution in patients with documented hypersensitivity to penicillins or other beta-lactams (cross-reactivity possible)
- Caution in patients with severe renal dysfunction (dose interval adjustment may be required)
Adverse effects
- Pain at IM injection site
- Thrombophlebitis (IV administration)
- Hypersensitivity reactions (rash, fever, anaphylaxis)
- Bleeding tendencies (hypoprothrombinemia due to NMTT side chain)
- Gastrointestinal flora alteration (diarrhea, superinfections)
- Rarely: nephrotoxicity, neurotoxicity, neutropenia, thrombocytopenia at high doses
Precautions
Cross-Reactivity: Use cautiously in patients with known penicillin allergies due to a 1-15% chance of cross-reactivity.
Renal Impairment: Elimination half-lives may be significantly prolonged in patients with severely diminished renal function; dosing intervals may need to be extended.
Laboratory Interference: May cause false-positive urine glucose tests (cupric sulfate method) and falsely elevated serum/urine creatinine (Jaffe reaction). Can also cause a false-positive direct Coombs' test.
Drug interactions
Potential for a disulfiram-like reaction (vomiting, etc.) due to the NMTT side chain.
Potential additive nephrotoxicity; do not mix together in the same syringe/fluid bag (administer separately). May have synergistic antibacterial activity.
Potential additive nephrotoxicity.
Monitoring
- Clinical efficacy (resolution of infection)
- Renal function in patients with pre-existing renal disease
- Signs of bleeding or coagulopathy (due to NMTT side chain)
Pharmacokinetics
Absorption
Not appreciably absorbed after oral administration; must be given parenterally to achieve therapeutic serum levels.
Distribution
Well distributed into most tissues, but has limited penetration into the CSF. Enters maternal milk in small quantities.
Metabolism
Minimal hepatic metabolism.
Elimination
Primarily excreted unchanged by the kidneys into the urine via both glomerular filtration and tubular secretion. Elimination half-lives are prolonged in severe renal dysfunction.
Overdose
Massive or chronic overdoses are required to cause significant adverse effects. Seizures are possible with extreme beta-lactam overdoses, particularly in patients with renal impairment. Treatment is supportive and symptomatic.
Available products
Formulations
- Powder for injection
Human-labeled
- Cefotetan Disodium Powder for Solution: 1 g, 2 g, & 10 g in 10 mL & 20 mL vials
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store sterile powder below 22°C and protect from light. Darkening of powder does not indicate lessened potency. After reconstitution with sterile water, the solution is stable for 24 hours at room temperature, 96 hours refrigerated, and at least 1 week if frozen at -20°C.
Client information
Cefotetan is an injectable antibiotic typically administered by your veterinarian in a hospital setting to treat serious bacterial infections.
- Side Effects: It is generally very well tolerated. However, watch for signs of stomach upset, diarrhea, or unusual bleeding/bruising.
- Allergies: Inform your veterinarian immediately if your pet has ever had an allergic reaction to penicillin or other cephalosporin antibiotics.
- Nursing: Let your veterinarian know if your pet is pregnant or nursing, as the drug can pass into milk and potentially cause mild diarrhea in nursing offspring.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.