Third-generation cephalosporin
Cefotaxime
Brand names: Claforan
Adult dose
Dose: 1–2g IV/IM q6–12h (max 12g/day in severe infection)
Route: IV / IM
Frequency: q6–12h
Clinical pearls
- UKHSA / NICE: meningitis empirical therapy in adults (alternative to ceftriaxone where calcium-containing solutions preclude ceftriaxone use)
- NICE NG217 epilepsy / NG52 children's meningitis
- Less calcium-precipitate risk than ceftriaxone — preferred in neonates
Contraindications
- Severe beta-lactam hypersensitivity
- Neonates with hyperbilirubinaemia (relative)
Side effects
- GI upset
- C. difficile
- Hypersensitivity
- Eosinophilia
- Phlebitis
- Pseudolithiasis (rare)
Interactions
- Probenecid
- Aminoglycosides (synergy / toxicity)
Monitoring
- FBC
- LFTs
- Renal
- C. diff
Reference: BNF; UKHSA; NICE NG52; SmPC; https://bnf.nice.org.uk/drugs/cefotaxime/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023