Indications
Cefotetan is an injectable antibiotic used to treat serious bacterial infections, including infections of the lungs, urinary tract, skin and soft tissues, bones and joints, abdomen and female pelvic organs (gynaecological infections). It is also given just before certain operations, such as abdominal, bowel or gynaecological surgery and caesarean section, to prevent infection.
How It Works
Cefotetan belongs to the cephamycin group, which is closely related to the cephalosporins. It attaches to proteins that bacteria use to build their cell walls and stops the wall forming properly, so the bacteria burst and die. It is active against many common bacteria, including some anaerobes (bacteria that live without oxygen) found in the bowel and pelvis.
Dosage and Administration
Cefotetan is given by a doctor or nurse as an injection into a vein (IV) or deep into a muscle (IM). The dose, how often it is given and how long treatment lasts are decided by the doctor, based on the type and severity of infection, body weight and kidney function. For surgery, a single dose is usually given shortly before the operation. Dose adjustment is needed when the kidneys are not working well.
Interactions
- Alcohol: drinking alcohol during treatment and for at least 72 hours after the last dose can cause flushing, headache, nausea, vomiting and a fast heartbeat (a disulfiram-like reaction).
- Anticoagulants such as Warfarin, and other medicines that affect clotting: increased risk of bleeding.
- Aminoglycoside antibiotics such as Gentamicin and strong diuretics such as Furosemide may add to the risk of kidney problems.
- It can affect some laboratory tests, such as tests for sugar in urine and the Coombs test.
Contraindications
- Allergy to Cefotetan, other cephalosporins or cephamycins.
- Previous haemolytic anaemia (destruction of red blood cells) caused by a cephalosporin.
- Use with great caution, or avoid, in people with a history of severe allergy to penicillins.
Side Effects
Side effects can include diarrhoea, nausea, rash, itching, pain or swelling at the injection site, and changes in liver tests or blood counts. It may lower vitamin K-dependent clotting factors and cause bleeding. A rare but serious effect is immune haemolytic anaemia, in which red blood cells are destroyed.
Get urgent medical help if you have signs of a severe allergic reaction (swelling of the face or throat, wheezing, collapse), severe or bloody diarrhoea, unusual bleeding or bruising, dark urine, yellowing of the skin or eyes, sudden paleness or tiredness, or a blistering rash.
Pregnancy and Lactation
Cephalosporin-type antibiotics are generally considered acceptable in pregnancy when needed, and Cefotetan is used to prevent infection during caesarean section. Small amounts pass into breast milk; breastfeeding can usually continue, but tell the doctor if the baby develops diarrhoea, thrush or rash.
Precautions and Warnings
- Tell the doctor about any previous allergy to antibiotics.
- Kidney function, blood counts and clotting tests may be monitored, especially in elderly, malnourished or very ill patients.
- Vitamin K may be given to people at risk of bleeding.
- Prolonged use can allow resistant germs or fungi to grow.
- Avoid alcohol during and for 72 hours after treatment.
Overdose
Because it is given in hospital, overdose is uncommon. Very high levels, especially with kidney failure, can cause seizures (fits) and bleeding. Treatment is supportive, and dialysis may help remove the drug.
Therapeutic Class
Antibiotic, second-generation cephalosporin (cephamycin).
Storage
Store as directed on the pack, usually below 30°C, dry, away from light and out of the reach of children. Prepared solutions should be used within the time stated by the manufacturer.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.