[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Beta-lactams](https://durgical.com/en/pharmacology/classes/beta-lactams/) › Cefotaxime [Pharmacology](https://durgical.com/en/pharmacology/) · [Beta-lactams](https://durgical.com/en/pharmacology/classes/beta-lactams/) # Cefotaxime A third-generation intravenous cephalosporin that crosses inflamed meninges; used for meningitis and sepsis, including in newborns. Updated 2026-11-01 - Class: [Beta-lactams](https://durgical.com/en/pharmacology/classes/beta-lactams/) - Enzyme: Penicillin-binding proteins (bacterial transpeptidases) - ATC code: J01DD01 - WHO Model List of Essential Medicines ✂**Penicillin-binding proteins (bacterial transpeptidases)**Cefotaxime ⓘ The figure shows Streptococcus pneumoniae PBP1b acylated by cefotaxime; the ligand is the bound form, which loses its 3' group. **Target in 3D:** Penicillin-binding proteins (bacterial transpeptidases). PDB structure 2XD1 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/2XD1) · Drag to rotate · pinch to zoom ## Mechanism of action Cefotaxime acylates the PBPs and blocks wall synthesis. It is stable to many β-lactamases and very active against pneumococci, meningococci, Haemophilus influenzae, gonococci and enteric bacteria. Its desacetyl metabolite is also bactericidal. It does not cover Listeria, enterococci or Pseudomonas, and ESBLs hydrolyse it. - Reaches the cerebrospinal fluid when the meninges are inflamed - Acylates the PBPs of pneumococci, meningococci and Haemophilus - Peptidoglycan cross-linking stops - The bacterium lyses ## Pharmacokinetics **Absorption** Intravenous or intramuscular. **Metabolism** Partly converted to desacetylcefotaxime, an active metabolite. **Elimination** By the kidney. **Half-life** About 1 hour in adults; longer in low-birth-weight newborns. ## Indications - Meningitis and ventriculitis due to meningococci, H. influenzae, pneumococci or enteric bacteria; in newborns, with ampicillin. [Bacterial meningitis →](https://durgical.com/en/conditions/bacterial-meningitis/) - Septicaemia. [Sepsis and septic shock →](https://durgical.com/en/conditions/sepsis-and-septic-shock/) - Lower respiratory tract infections, including pneumonia. [Community-acquired pneumonia →](https://durgical.com/en/conditions/community-acquired-pneumonia/) - Gonorrhoea. [Gonorrhoea →](https://durgical.com/en/conditions/gonorrhoea/) - Urinary tract infections due to susceptible gram-negatives. [Urinary tract infection (acute cystitis) →](https://durgical.com/en/conditions/urinary-tract-infection/) ## Adverse effects ### Common - Pain, hardening and phlebitis at the injection site - Rash, itching, fever - Diarrhoea, nausea ### Serious (rare, important) - Anaphylaxis - Clostridioides difficile diarrhoea, from mild to severe colitis - Potentially fatal arrhythmias after a rapid bolus through a central venous catheter ## Contraindications - History of hypersensitivity to this or another cephalosporin; caution, and sometimes contraindication, after anaphylaxis to penicillins or other β-lactams ## Key interactions **Probenecid** Reduces tubular secretion: higher and longer-lasting β-lactam levels. **Aminoglycosides** They can be combined, but kidney function is monitored because of aminoglycoside kidney and ear toxicity. ## What is monitored - Kidney function - Clinical response and cerebrospinal fluid cultures in meningitis ## Administration and safety - Intravenous or intramuscular. - Never as a rapid bolus through a central line: serious arrhythmias have been reported; it is injected slowly or infused. - Do not confuse cefotaxime with cefoxitin or ceftriaxone. ## Nursing care - Before the first dose: ask about allergy to penicillins, cephalosporins and other β-lactams, and what the reaction was. - Monitor heart rhythm when given centrally. - Check the injection site for phlebitis. - Teach the patient to report watery or bloody diarrhoea, even weeks after the course ends. ## Pregnancy and breastfeeding Animal studies showed no fetal harm and there are no controlled studies in pregnant women; used if clearly needed. ## Memory aid 'Cefo-TAXI to the meninges': the third-generation taxi that carries the drug into inflamed cerebrospinal fluid; just never push it as a bolus through a central line. ## Test yourself Think of the answer, then tap the question to see it. ## Which cefotaxime metabolite contributes to its effect? Desacetylcefotaxime, its main metabolite, which is also bactericidal and is cleared by the kidney. ## What is the risk of giving cefotaxime as a rapid bolus through a central line? Potentially fatal arrhythmias; it is given slowly or as an infusion. ## Which drug is added to cefotaxime for neonatal meningitis, and why? Ampicillin, to cover Listeria monocytogenes (and enterococci), which do not respond to cephalosporins. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/cefotaxime/) ## Related drugs - [Ceftriaxone](https://durgical.com/en/pharmacology/ceftriaxone/) - [Ampicillin](https://durgical.com/en/pharmacology/ampicillin/) - [Cefixime](https://durgical.com/en/pharmacology/cefixime/) ## Related conditions - [Bacterial meningitis](https://durgical.com/en/conditions/bacterial-meningitis/) - [Sepsis and septic shock](https://durgical.com/en/conditions/sepsis-and-septic-shock/) - [Community-acquired pneumonia](https://durgical.com/en/conditions/community-acquired-pneumonia/) - [Gonorrhoea](https://durgical.com/en/conditions/gonorrhoea/) - [Urinary tract infection (acute cystitis)](https://durgical.com/en/conditions/urinary-tract-infection/) [← Back to the class: Beta-lactams](https://durgical.com/en/pharmacology/classes/beta-lactams/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Cefotaxime Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a682765.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - CEFOTAXIME injection, powder, for solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ed23b6bc-32c7-4c50-a53d-313ae78e5623) (DailyMed (U.S. National Library of Medicine), 2026); [RCSB PDB - 2XD1: ACTIVE SITE RESTRUCTURING REGULATES LIGAND RECOGNITION IN CLASS A PENICILLIN-BINDING PROTEINS](https://www.rcsb.org/structure/2XD1) (RCSB Protein Data Bank, 2026); Farmacología básica y clínica (Katzung), cap. 43 (McGraw Hill, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/cefotaxime/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/cefotaxime/