세포탁심
Cefotaxime
Cefotaxime sodium
다른 이름: Claforan · cefotaximum natricum · CTX · HR-756 · RU-24756
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
파충류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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 |
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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 |
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
세포탁심은 그람 양성균 및 그람 음성균 모두에 대해 광범위한 항균 활성을 갖는 3세대 주사용 세팔로스포린 항생제입니다.
주요 임상적 특징은 다음과 같습니다:
- 확장된 그람 음성균 커버리지: 장내세균과(예: 클레브시엘라, 대장균, 살모넬라, 프로테우스)에 매우 효과적입니다.
- 혐기성 균 활성: 박테로이데스 프라질리스 및 클로스트리디움 종을 포함한 많은 혐기성 균에 효과적입니다.
- 중추신경계(CNS) 침투: 1세대 및 대부분의 2세대 세팔로스포린과 달리, 뇌수막에 염증이 있을 때 뇌척수액(CSF)에서 치료 농도에 도달하므로 세균성 뇌수막염 및 척수 감염에 유용한 옵션입니다.
- 투여: 경구로 거의 흡수되지 않으므로 반드시 비경구(IV, IM, SC)로 투여해야 합니다. 부작용을 최소화하기 위해 정맥 주사는 천천히(3-5분 이상) 투여해야 합니다.
임상 팁: 많은 그람 음성 호기성 균에 대해 우수한 활성을 보이지만, 녹농균(Pseudomonas aeruginosa)에 대한 효능은 변동성이 크며 임상적으로 실망스러운 경우가 많습니다. 디스크 확산법 감수성 검사 시 30마이크로그램 세포탁심 디스크를 사용해야 합니다.
작용 기전
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.
안전성·주의사항
금기사항
- Patients with a documented history of hypersensitivity to cephalosporins
부작용
- 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
주의
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).
약물 상호작용
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.
모니터링
- Clinical efficacy (resolution of infection signs)
- Renal function parameters (BUN, creatinine, urinalysis) in compromised patients or those on concurrent nephrotoxic drugs
약동학
반감기
흡수
Not appreciably absorbed after oral administration; must be given parenterally. Bioavailability is approximately 87-98% after IM injection and ~100% after SC injection.
분포
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.
대사
Partially metabolized by the liver to desacetylcefotaxime, which exhibits some antibacterial activity. This is further degraded to inactive metabolites.
배설
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.
과다투여
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.
제품
제형
- Powder for injection
- Premixed frozen injection solution
인용의약품
- 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
규제 현황
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.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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).
보호자 정보
세포탁심은 강력한 주사용 항생제로, 일반적으로 심각한 감염을 치료하기 위해 동물병원 내에서 투여됩니다.
- 투여 방법: 위장관을 통해 흡수되지 않으므로 반드시 주사(정맥, 근육 또는 피하)로 투여해야 합니다.
- 부작용: 근육 주사는 통증을 유발할 수 있습니다. 주사 부위에 부기, 발적 또는 통증의 징후가 있는지 관찰하십시오.
- 알레르기: 반려동물이 과거에 페니실린이나 다른 세팔로스포린계 약물에 알레르기 반응을 보인 적이 있다면 즉시 수의사에게 알리십시오.
- 위장 장애: 많은 항생제와 마찬가지로 장내 정상 세균총을 변화시켜 간혹 설사를 유발할 수 있습니다. 설사가 심해지거나 혈변이 나타나면 수의사에게 연락하십시오.
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