Cefotetan


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV/IM Bone and joint infections; Gynaecological infections; Intra-abdominal infections; Lower respiratory tract infections 1-2 g 12 hourly. Severe: 2 g 12 hourly. Life threatening infections: 3 g 12 hourly up to max 6 g/day. Skin and skin structure infections Mild to moderate: 1 g 12 hourly. Severe: 2 g 12 hourly. K. pneumoniae infections: 1-2 g 12 hourly. UTI 1-4 g/day. All doses to be given for 5-10 days by deep IM inj, slow IV inj over 3-5 minutes, or intermittent IV infusion over 30 minutes. IV Pelvic inflammatory disease Combined with doxycycline: 2 g 12 hourly for 5-10 days. Prophylaxis of surgical infections 1-2 g 30-60 minutes before the procedure or when the umbilical cord is clamped in caesarean section.
Dosage Details
Intramuscular, Intravenous
Bone and joint infections, Gynaecological infections, Intra-abdominal infections, Lower respiratory tract infections
Adult: Usual dose: 1-2 g 12 hourly for 5-10 days depending on the severity of the infection. Severe: 2 g 12 hourly. Life threatening infections: 3 g 12 hourly up to max 6 g daily. All doses to be given by deep IM inj, slow IV inj over 3-5 minutes, or intermittent IV infusion over 30 minutes.

Intramuscular, Intravenous
Skin and skin structure infections
Adult: Mild to moderate: 1 g 12 hourly. Severe: 2 g 12 hourly. K. pneumoniae infections: 1-2 g 12 hourly. All doses to be given for 5-10 days by deep IM inj, slow IV inj over 3-5 minutes, or intermittent IV infusion over 30 minutes.

Intramuscular, Intravenous
Urinary tract infections
Adult: 1-4 g daily for 5-10 days depending on the severity of the infection by deep IM inj, slow IV inj over 3-5 minutes, or intermittent IV infusion over 30 minutes.

Intravenous
Prophylaxis of surgical infections
Adult: 1-2 g 30-60 minutes before the procedure or when the umbilical cord is clamped in caesarean section.

Intravenous
Pelvic inflammatory disease
Adult: In combination with doxycycline: 2 g 12 hourly for 5-10 days.
Renal Impairment
ESRD patient on haemodialysis: One quarter of the usual dose 24 hourly on days between dialysis and half of the usual dose on the day of dialysis.
CrCl (mL/min) Dosage
<10 Usual dose 48 hourly or one quarter of the usual dose 12 hourly.
10-30 Usual dose 24 hourly or half of the usual dose 12 hourly.
Reconstitution
IV: Reconstitute vials labelled as containing 1 g and 2 g with 10 or 20 mL respectively, of sterile water for inj. Further dilute with 50-100 mL of dextrose 5% inj or NaCl 0.9% inj for IV infusion. IM: Add 2 or 3 mL of sterile or bacteriostatic water for inj, NaCl 0.9% inj or 0.5% or 1% lidocaine hydrochloride inj to vials labelled as containing 1 g and 2 g, to provide a solution containing 400 mg/mL and 500 mg/mL, respectively.
Contraindications
Hypersensitivity to cefotetan and other cephalosporins. History of cephalosporin associated haemolytic anaemia.
Special Precautions
Patient with history of penicillin allergy, gastrointestinal disease (e.g. colitis), risk factors for INR elevation (e.g. malnourished or cancer patient). Renal and hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Anaphylaxis, elevated INR and bleeding, bacterial or fungal superinfection.
Blood and lymphatic system disorders: Agranulocytosis, eosinophilia, leucopenia, neutropaenia, thrombocytosis, thrombocytopaenia.
Gastrointestinal disorders: Diarrhoea, nausea.
Injury, poisoning and procedural complications: Injection site phlebitis.
Investigations: Increased SGOT, SGPT prolonged prothrombin time, increased BUN, and serum creatinine.
Potentially Fatal: Severe haemolytic anaemia, pseudomembranous colitis.
IM/IV/Parenteral: B
MonitoringParameters
Monitor coagulation parameters (e.g. INR/prothrombin time, haematologic parameters (e.g. CBC with differential), LFT and renal function periodically. Monitor signs and symptoms of haemolytic anaemia.
Drug Interactions
Enhanced nephrotoxic effect with aminoglycosides. Increased serum concentration with probenecid. May enhance the anticoagulant effect of vitamin K antagonists (e.g. warfarin). May diminish the therapeutic effect of Na picosulfate, BCG, typhoid and cholera vaccines.
Food Interaction
Disulfiram-like reaction may occur when given with alcohol.
Lab Interference
Positive direct Coombs test results. False-positive reaction in urinary glucose test using Benedict’s solution, Clinitest, Fehling’s solution. False-positive serum or urine creatinine with Jaffe’ reaction.
Action
Description: Cefotetan is a 2nd generation cephalosporin which inhibits bacterial cell wall biosynthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn prevents the final transpeptidation step of peptidoglycan synthesis, thus arresting cell wall assembly resulting in bacterial cell death.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: 1-3 hours (IM).
Distribution: Widely distributed into body tissues and fluids (including bile, gallbladder, kidney, skin, tonsils, uterus, sputum, prostatic and peritoneal fluids). Crosses the placenta and enters breast milk (small amounts). Plasma protein binding: Approx 88%.
Excretion: Via urine (approx 51-81% as unchanged drug). Elimination half-life: Approx 3-4.6 hours.
Chemical Structure

Chemical Structure Image
Cefotetan

Source: National Center for Biotechnology Information. PubChem Database. Cefotetan, CID=53025, https://pubchem.ncbi.nlm.nih.gov/compound/Cefotetan (accessed on Jan. 21, 2020)

Storage
Store between 20-25°C.
MIMS Class
ATC Classification
J01DC05 - cefotetan ; Belongs to the class of second-generation cephalosporins. Used in the systemic treatment of infections.
References
Anon. Cefotetan Disodium. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 07/03/2018.

Anon. Cefotetan. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 07/03/2018.

Buckingham R (ed). Cefotetan. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/03/2018.

Cefotan Injection (GlaxoSmithKline for AstraZeneca Pharmaceuticals, LP). U.S. FDA. https://www.fda.gov/. Accessed 07/03/2018.

Cefotan Injection, Solution Injection, Powder for Solution (AstraZeneca Pharmaceuticals, LP). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/03/2018.

Disclaimer: This information is independently developed by MIMS based on Cefotetan from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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