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Prior to initiation of Cefotaxime therapy, careful inquiry should be made concerning previous hypersensitivity reaction to Cefotaxime, cephalosporins, penicillins, or other β-lactam drugs. There is clinical and laboratory evidence of partial cross-allergenicity among cephalosporins and other β-lactam antibiotics including penicillins.
To reduce development of drug-resistance bacteria and maintain effectiveness of Cefotaxime and other antibacterial, the drug should be used only for the treatment or prevention of infections proven or strongly suspected to be caused by susceptible bacteria.
Similar to anti-infectives, prolonged use of Cefotaxime may result in over-growth of nonsusceptible organisms, especially Candida and others.
Diarrhea occurring during treatment may be symptomatic of Clostridium difficile-associated diarrhea and colitis which has been reported with almost all anti-infectives, including cefotaxime, and may range in severity from mild diarrhea to fatal colitis. So it should have been monitoring diarrhea, colitis including pseudomembranous colitis closely during treatment with Cefotaxime and after treatment.
Cefotaxime should be used with caution in elderly, patients with renal impairment.
Seizures have been reported with several cephalosporins, particularly in patients with renal impairment in whom dosage of the drug was not reduced. The dosage should be modified according to the creatinine clearance calculated.
Arrhythmias were reported in several patients who received Cefotaxime by rapid (less than 1 minute) bolus injection.
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