Cefotiam

Medical uses

This drug is indicated for prophylaxis for surgical infection, postoperative infections, bacterial sepsis, bone and joint infections, cholangitis, cholecystitis, peritonitis, prostatitis, pyelonephritis, respiratory tract infections, skin and soft tissue infections, cystitis, urethritis, and infections caused by susceptible organisms. It does not have activity against Pseudomonas aeruginosa.

Dosage

For adults, the dose is up to 6 grams daily by intravenous or intramuscular route in divided doses according to the severity of infection. In patients with renal impairment a dose reduction may be needed.

Spectrum of bacterial susceptibility

Cefotiam has a broad spectrum of activity and has been used to treat infections caused by several enteric bacteria and bacteria responsible for causing skin infections. The following represents MIC susceptibility data for a few medically significant bacteria.

• Bacteroides fragilis: - 16 - 128 μg/ml
• Clostridioides difficile: 128 μg/ml
• Staphylococcus aureus: 0.25 - 32 μg/ml

Adverse effects

Side effects include nausea and vomiting, diarrhoea, hypersensitivity reactions, nephrotoxicity, convulsions, CNS toxicity, hepatic dysfunction, haematologic disorders, pain at injection site, thrombophlebitis, pseudomembranous colitis, and superinfection with prolonged use.

Mechanism of action

Cefotiam inhibits the final cross-linking stage of peptidoglycan production, thus inhibiting bacterial cell wall synthesis. It has similar or less activity against Gram-positive staphylococci and streptococci, but is resistant to some beta-lactamases produced by Gram-negative bacteria. It is more active against many of the Enterobacteriaceae including Enterobacter, E. coli, Klebsiella, Salmonella and indole-positive Proteus species.

In clinical use, high concentrations of cefotiam are observed in several tissues (kidney, heart, ear, prostate, and genital tract), as well as in fluids and secretions (bile, ascitic fluid).

References

References

1. (2006). "Analogue-based Drug Discovery". John Wiley & Sons.
2. (24 February 2014). "Cefotiam hydrochloride". TOKU-E.