Cefotetan

DEA Class; Rx

Common Brand Names; Cefotan

Indicated for the treatment of lower respiratory tract infections and bone and joint infections due to susceptible organisms.

Hypersensitivity to drug or excipients

Previously experienced cephalosporin-associated hemolytic anemia

• Diarrhea (1%)
• Hepatic enzyme elevation (1%)
• Hypersensitivity reaction (1%)
• Prolongation of bleeding time
• Neutropenia
• Thrombocytopenia
• Immune-mediated hemolytic anemia

Reduce dosage by 1/2 if <10-30 mL/min creatinine clearance and by 1/4 if <10 mL/min; (high doses may cause CNS toxicity); bacterial or fungal overgrowth of nonsusceptible organisms may occur with prolonged or repeated therapy

Inappropriate for pediatric mild-moderate infections (AAP)

Before initiating therapy, make careful inquiry to determine whether patient has had previous cross-hypersensitivity reaction to beta-lactams; if allergic reaction to this drug occurs, discontinue drug; serious hypersensitivity reactions may require treatment with epinephrine and other emergency measures, including oxygen, intravenous fluids, antihistamines corticosteroids, pressor amines, and airway management

In common with many other broad-spectrum antibiotics, this drug may be associated with a fall in prothrombin activity and, possibly, subsequent bleeding; those at increased risk include patients with renal or hepatobiliary impairment or poor nutritional state, the elderly, and patients with cancer; prothrombin time should be monitored and exogenous vitamin K administered as indicated

Prescribing this antibiotic in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria

As with other broad-spectrum antibiotics, prolonged use may result in overgrowth of nonsusceptible organisms; careful observation of the patient is essential; if superinfection occurs during therapy, appropriate measures should be taken

This antibiotic should be used with caution in individuals with a history of gastrointestinal disease, particularly colitis

Available data from published observational studies and case reports over several decades with drug use in pregnant women have not established a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes

Published literature reports that drug is present in human milk at low levels following intravenous administration; there is no information regarding effects of cefotetan on milk production or the breastfed infant