Training session 8
Tax-O-Bid
Category :
TAXOBID contains Cefotaxime
Cefotaxime is a broad spectrum, third generation cephalosporin for parenteral use. It has a bactericidal action
Cefotaxime is stable against beta lactamase producing microorganisms
Mechanism of action :
Cefotaxime is a betalactam antibiotic. It inhibits the cell wall synthesis of the bacteria, thus killing the bacteria in the process.
Detailed mechanism of action
Absorption :
Cefotaxime should not be administered orally. The drug should be administered by intravenous (IV) or intramuscular route (IM)
Distribution :
Cefotaxime is well distributed in tissues and fluid.
Cefotaxime diffuses into the Cerebro Spinal Fluid (CSF) significantly, in the presence of inflamed meninges
Metabolism :
Cefotaxime is deacteylated in the body rapidly. The desacetyl metabolite is generally less active than the parent compound, but the invitro antibacterial activity depends upon the species. Desacetylcefotaxime is further metabolised to an open lactone form that has no antimicrobial activity.
CEFOTAXIME FORM ----------------DESACETYLCEFOTAXIME---------------OPEN LACTONE
...Active form activity

Twice as active as Cefotaxime to.32 times less active

No antimicrobial..
Excretion :
20-36% of the drug is excreted unchanged in the urine
15-25% of the drug is excreted as the desactyl metabolite
20-25% is excreted as the open lactone derivative
The mean elimination half life depends upon the route and method of administration
Type of Administration
Mean elimination half life
Intramuscular injection
1.45 hours
Intravenous injection
1.06 hours
30 minute intravenous infusion
1.13 hours
Microbiology :
  1. Cefotaxime has a broad spectrumof activity
  2. Staphylococci ( including penicillinase producing strains)
  3. Streptococci
  4. Klebsiella
  5. Serratia
  6. Haemophilus influenzae
  7. Neisseria species - including penicillin resistant gonococci
  8. Proteus genera
  9. E coli ( including gentamycin resistant strains)
Indication and usage :
  • Upper and lower respiratory tract infections
  • Urinary tract infections
  • Septicaemia
  • Intra - abdominal infections
  • Gonorrhoea
  • ENT infections
  • Soft tissue infections
  • Bone and joint infections
  • Meningitis
Contraindications:
Known allergy to Cephalosporins.
Warnings :
In an individual who is allergic to beta lactam antibiotics, the probability of allergy manifestation to Cefotaxime cannot be ruled out.
Subsequent to the administration of Cefotaxime, patients who present with diarrhoea should be considered for diagnosis of pseudomembranous colitis
Precautions :
  • Use with caution in patients with known allergy to penicillins and other cephalosporins.
  • Caution should be exercised in patients receiving aminoglycoside antibiotic or potent diuretics such as frusemide.
  • When administered as intermittent intravenous injection, Cefotaxime should be given over a period of 3-5 minutes. This is because life threatening arrhythmias has been reported in patients who received rapid IV administration
  • Superinfection.
  • Pseudomembranous colitis
  • If Cefotaxime is combined with Lignocaine ( local anaesthetic) to reduce the pain at the site of the injection, this point should be noted: Repeated use of Lignocaine should be avoided in patients with severe liver disease or decreased hepatic blood flow.
Pregnancy and Lactation - The usage of Cefotaxime in Pregnancy has not been established. Cefotaxime is excreted inbreast milk. Hence the drug should not be administered to nursing mothers unless the expected benefits outweigh the potential risks
Adverse reactions :
Anaphylactic Reactions
Angioedema, bronchospasm, rarely shock
Skin
Rash, Pruritus, Urticaria, erythema multiforme, Stevens-Johnson syndrome
Blood
Leukopenia, Granulocytopenia and rarely agranulocytosis
Local
Pain, Phlebitis, tenderness
Gastrointestinal
Nausea, Diarrhoea, rarely pseudomembranous colitis
Dosage:
1. UTI - 2 grams daily in 2 divided doses
2. Prevention of postoperative infections-
a. Vaginal or abdominal hysterectomy -
1 gram IM, 30 to 60 minutes before incision and repeated after completion of surgery and 8 hourly intervals for a total time period of 24 hours.
b. Caesarean Section -
1 gram IV after the cord has been clamped and thereafter at 6 and 12 hours.
c. Biliary Surgery -
1 gram IV at induction
Gonohorrea:
Uncomplicated Gonorrhoea due to non beta lactamase producing micro organisms
One single IM dose of 1 gram + Probenecid 1 Gram orally , to be given one hour earlier
Paediatrics:
The usual dosage range is 100-150mg/kg/day in 3 to 4 divided doses. In severe infections, doses upto 200mg/kg/day may be required

For the management of neonatal meningitis -

0-1 week of age: 50mg/kg IV every 12 hours
1-4 weeks of age: 50mg/kg IV every 8 hours
Product formulation :
Cefogram (ceftriaxone for injection) -1gm/500 mg/250 mg/125 mg
Benefits :
The best benefits of tax-o-bid is the powerful activity against the gram negative organisms this is much more powerful than first and second generation cephalosporins.
Besides, being a 3rd generation cephalosporins, Tax-O-Bid has activity even against Beta lactamase providing strains of bacteria.
Competition :
Brand
Company
Taxmin
Alkem
Omnatax
HMRs
Biotax
Biochem
C-Tax
Emcure
Cefantral
Lupin
Omnicef
Aristo
 
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