Cefotaxima
Cefotaxime
Cefotaxime sodium
También conocido como: Claforan · cefotaximum natricum · CTX · HR-756 · RU-24756
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Soft tissue infections | 22 mg/kg IV, IM or SC q8h for 7 days or less or 50 mg/kg IV or IM q12h for 7 days or less | IV, IM, SC | q8h or q12h | 7 days or less | 🌎 NA |
| Orthopedic infections | 20-40 mg/kg IV, IM or SC q6-8h for 7 days or less | IV, IM, SC | q6-8h | 7 days or less | 🌎 NA |
| Severe bacteremia | 20-80 mg/kg IV q6h or 10-50 mg/kg IV q4-6h for as long as necessary | IV | q4-6h | As long as necessary | 🌎 NA |
| Susceptible infections | 25-50 mg/kg IV, IM or SC q8h | IV, IM, SC | q8h | — | 🌎 NA |
| Sepsis | 20-80 mg/kg IV, IM q8h | IV, IM | q8h | — | 🌎 NA |
| CNS infections (spinal cord) | 25 mg-50 mg/kg IV, IM q8h | IV, IM | q8h | — | 🌎 NA |
| Acute sepsis or serious susceptible infections | 40-50 mg/kg | IV/IM/SC | q8h | Until clinical resolution | 🌍 EU |
| Susceptible infections | 10-20 mg/kg | IV/IM/SC | q12h | Until clinical resolution | 🌍 EU |
- Acute sepsis or serious susceptible infections: Standard recommended dose.
- Susceptible infections: Lower dose suggested by some authors to have good clinical efficacy.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Severe bacteremia | 20-80 mg/kg IV or IM q6h as long as necessary | IV, IM | q6h | As long as necessary | 🌎 NA |
| Susceptible infections | 25-50 mg/kg IV, IM or SC q8h | IV, IM, SC | q8h | — | 🌎 NA |
| Sepsis | 20-80 mg/kg IV, IM q8h | IV, IM | q8h | — | 🌎 NA |
| CNS infections (spinal cord) | 25 mg-50 mg/kg IV, IM q8h | IV, IM | q8h | — | 🌎 NA |
| To prevent bacterial colonization of pancreas in severe pancreatitis, anorexia, or SIRS | 50 mg/kg IM q8h | IM | q8h | — | 🌎 NA |
| Acute sepsis or serious susceptible infections | 40-50 mg/kg | IV/IM/SC | q8h | Until clinical resolution | 🌍 EU |
- Acute sepsis or serious susceptible infections: Standard recommended dose.
Aves
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections (most birds) | 50-100 mg/kg IM three times a day | IM | TID | — | 🌎 NA |
| Bacterial infections, bacterial hepatitis | 75-100 mg/kg IM or IV q4-8h | IM, IV | q4-8h | — | 🌎 NA |
| Susceptible infections in ratites (young birds) | 25 mg/kg IM 3 times daily | IM | TID | — | 🌎 NA |
| Susceptible infections | 75 mg/kg IM q8h | IM | q8h | — | 🌎 NA |
- Susceptible infections (most birds): May be used with aminoglycosides, but nephrotoxicity may occur. Reconstituted vial good for 13 weeks if frozen.
Reptiles
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections | 20-40 mg/kg IM once daily for 7-14 days | IM | q24h | 7-14 days | 🌎 NA |
| Susceptible infections in chelonians | 20-40 mg/kg IM q24h | IM | q24h | — | 🌎 NA |
| Nebulized antibiotic therapy | 100 mg twice daily | Nebulization | BID | — | 🌎 NA |
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections in foals | 40 mg/kg IV q6h | IV | q6h | — | 🌎 NA |
| Meningitis in foals | 40 mg/kg IV 3-4 times a day | IV | 3-4 times a day | — | 🌎 NA |
| Systemic therapy in foals | 20-30 mg/kg IV or IM q6-8h | IV, IM | q6-8h | — | 🌎 NA |
| Regional perfusion for adjunctive treatment of septic arthritis in foals | 1 gram cefotaxime in 20 mL of saline. Tourniquet above and below joint. Inject antibiotic solution and leave tourniquet in place for 20 minutes. | Regional perfusion | Once | 20 minutes | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La cefotaxima es un antibiótico cefalosporínico parenteral de tercera generación con un amplio espectro de actividad contra bacterias grampositivas y gramnegativas.
Las características clínicas clave incluyen:
- Cobertura extendida contra Gram-negativos: Altamente eficaz contra Enterobacteriaceae (p. ej., Klebsiella, E. coli, Salmonella, Proteus).
- Actividad anaeróbica: Eficaz contra muchos anaerobios, incluidos Bacteroides fragilis y Clostridium spp.
- Penetración en el SNC: A diferencia de las cefalosporinas de primera y la mayoría de las de segunda generación, la cefotaxima alcanza concentraciones terapéuticas en el líquido cefalorraquídeo (LCR) cuando las meninges están inflamadas, lo que la convierte en una opción valiosa para la meningitis bacteriana y las infecciones de la médula espinal.
- Administración: Debe administrarse por vía parenteral (IV, IM, SC), ya que no se absorbe de forma apreciable por vía oral. La administración IV debe ser lenta (durante 3-5 minutos) para minimizar las reacciones adversas.
Perla clínica: Aunque tiene una excelente actividad contra muchos aerobios gramnegativos, su eficacia contra Pseudomonas aeruginosa es variable y a menudo clínicamente decepcionante. Se debe utilizar un disco de cefotaxima de 30 microgramos para las pruebas de susceptibilidad de Kirby-Bauer.
Mecanismo de acción
Cefotaxime is a time-dependent, bactericidal antibiotic.
- Mechanism: It binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall → inhibits the third and final stage of bacterial cell wall peptidoglycan synthesis → leads to cell lysis and death mediated by bacterial cell wall autolytic enzymes (autolysins).
- Metabolism: It is partially metabolized in the liver to desacetylcefotaxime, an active metabolite that works synergistically with the parent compound to enhance antibacterial activity.
Seguridad y advertencias
Contraindicaciones
- Patients with a documented history of hypersensitivity to cephalosporins
Efectos adversos
- Pain at the IM injection site
- Thrombophlebitis (after IV administration)
- Hypersensitivity reactions (rashes, fever, eosinophilia, anaphylaxis)
- Antibiotic-associated diarrhea (alteration of gut flora)
- Sterile abscesses or local tissue reactions
- Rarely: Nephrotoxicity, neurotoxicity (at high doses), neutropenia, agranulocytosis, thrombocytopenia, hepatitis
Precauciones
Use with caution in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., penicillins, carbapenems) due to potential cross-reactivity (estimated 1-15% in humans). Dosage adjustments may be necessary in patients with renal failure. May cause false-positive direct Coombs' tests, falsely elevated 17-ketosteroid urine values, and false-positive urine glucose determinations when using cupric sulfate solution tests (e.g., Clinitest).
Interacciones farmacológicas
Potential for additive nephrotoxicity. In vitro studies show synergistic antibacterial activity, but they must NOT be mixed in the same syringe or fluid bag.
Competitively blocks the renal tubular secretion of cefotaxime, significantly increasing its serum levels and prolonging its elimination half-life.
Bacteriostatic agents may antagonize the bactericidal activity of cephalosporins.
Bacteriostatic agents may antagonize the bactericidal activity of cephalosporins.
Synergistic antibacterial effect, but do not mix in the same syringe due to chemical incompatibility.
Increased risk of nephrotoxicity.
Loop diuretics may increase the risk of nephrotoxicity when used with cephalosporins.
Monitorización
- Clinical efficacy (resolution of infection signs)
- Renal function parameters (BUN, creatinine, urinalysis) in compromised patients or those on concurrent nephrotoxic drugs
Farmacocinética
Vida media
Absorción
Not appreciably absorbed after oral administration; must be given parenterally. Bioavailability is approximately 87-98% after IM injection and ~100% after SC injection.
Distribución
Widely distributed in body tissues including bone, prostatic fluid, aqueous humor, bile, ascitic, and pleural fluids. Enters the CSF in therapeutic levels when meninges are inflamed. Crosses the placenta (activity in amniotic fluid equals or exceeds maternal serum) and distributes into milk in low concentrations. Protein binding is 13-40% in humans. Volume of distribution at steady state in dogs is 480 mL/kg.
Metabolismo
Partially metabolized by the liver to desacetylcefotaxime, which exhibits some antibacterial activity. This is further degraded to inactive metabolites.
Eliminación
Primarily excreted in the urine via tubular secretion. Total body clearance is 10.5 mL/min/kg in dogs and ~3 mL/min/kg in cats.
Sobredosis
Acute cephalosporin overdoses are unlikely to cause significant life-threatening problems. However, massive overdoses may exacerbate adverse effects, potentially leading to neurotoxicity (seizures, encephalopathy), nephrotoxicity, or severe gastrointestinal upset. Treatment should consist of standard supportive care and monitoring.
Productos disponibles
Formulaciones
- Powder for injection
- Premixed frozen injection solution
Etiquetado para humanos
- Cefotaxime Sodium Powder for Injection: 500 mg, 1 g, 2 g, & 10 g in vials, bottles, infusion bottles & ADD-Vantage system vials
- Cefotaxime Sodium for Injection: 1 g & 2 g in infusion bottles, & premixed, frozen 50 mL
Estado regulador
Classified as a highest priority critically important antibiotic. Use is heavily restricted to cases where no other appropriate licensed veterinary medicine exists and culture/susceptibility testing justifies its use.
Subject to strict antimicrobial stewardship guidelines.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Sterile powder for injection should be stored at temperatures < 30°C and protected from light. Commercially available frozen injections should be stored at < -20°C. Powder or solutions may darken depending on storage conditions, which may indicate a loss in potency. Cefotaxime is unstable in solutions with a pH > 7.5 (e.g., sodium bicarbonate).
Información para el cliente
La cefotaxima es un potente antibiótico inyectable que generalmente se administra en un entorno hospitalario veterinario para tratar infecciones graves.
- Administración: Debido a que no se absorbe a través del tracto gastrointestinal, debe administrarse mediante inyección (IV, IM o bajo la piel).
- Efectos secundarios: Las inyecciones en el músculo pueden ser dolorosas. Observe el lugar de la inyección para detectar signos de hinchazón, enrojecimiento o dolor.
- Alergias: Si su mascota ha tenido una reacción alérgica a las penicilinas u otras cefalosporinas en el pasado, notifique a su veterinario de inmediato.
- Malestar gastrointestinal: Como ocurre con muchos antibióticos, puede alterar las bacterias normales del intestino, lo que ocasionalmente provoca diarrea. Comuníquese con su veterinario si la diarrea se vuelve grave o sanguinolenta.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.