Exploring the clinical pharmacokinetics and pharmacodynamics of third-generation cephalosporin, a cefotaxime: a systematic review

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Cefotaxime is a third-generation cephalosporin that is used to treat susceptible bacterial infections. This systematic review provides an in-depth analysis of all pharmacokinetic (PK) and pharmacodynamic (PD) parameters of cefotaxime in humans.A systematic search was conducted using the search engines Google Scholar, PubMed, Science Direct, and Cochrane Library to identify the relevant articles on the PK of cefotaxime.The healthy populations have shown a linear increase in area under the plasma concentration vs. time curve from zero to infinity (AUC0-∞) after receiving doses ranging from 250–2000 mg. One study has reported a decrease in cefotaxime clearance (CL) in patients with renal insufficiency compared to healthy participants, i.e. 129.8 ± 9.3 ml/min vs. 272.8 ± 43.9 ml/min. Moreover, a slight increase in the maximum plasma concentration (Cmax) of about 5.6% was observed when cefotaxime is co-administered with tazobactam. Therefore, cefotaxime depicts time-dependent killing above the minimum inhibitory concentration (MIC < 2 ug/ml), this property makes it suitable for managing infections caused by susceptible pathogens.This review compiles all the relevant PK and PD parameters of cefotaxime in healthy subjects. These data may assist health practitioners in adjusting the cefotaxime dose among renal failure patients to avoid toxicity.

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