Indications : התוויות

4.1.       Therapeutic indications

Properties: Cefotaxime Medo 1 gr is a broad-spectrum bactericidal cephalosporin antibiotic.
Cefotaxime Medo 1 gr is exceptionally active in vitro against Gram-negative organisms sensitive or resistant to first or second-generation cephalosporins. It is similar to other cephalosporins in activity against Gram-positive organisms.


Indication: Cefotaxime Medo 1 gr is indicated in the treatment of the following infections either before the infecting organism has been identified or when caused by bacteria of established sensitivity:
-      Septicaemias
-      Respiratory Tract Infections such as acute and chronic bronchitis, bacterial pneumonia, infected bronchiectasis, lung abscess and post-operative chest infections.
-      Urinary Tract Infections such as acute and chronic pyelonephritis, cystitis and asymptomatic bacteriuria.
-      Soft Tissue Infections such as cellulitis, peritonitis and wound infections.
-      Bone and Joint Infections such as osteomyelitis, septic arthritis.
-   Obstetric and Gynaecological Infections such as pelvic inflammatory disease.
-   Gonorrhoea particularly when penicillin has failed or is unsuitable.
-   Other Bacterial Infections, such as meningitis and other sensitive infections suitable for parenteral antibiotic therapy.
Prophylaxis:
Prophylaxis of infections in patients with reduced resistance.
Pre-operative prophylaxis in patients who are at increased risk from infection.
The administration of cefotaxime Medo 1 gr prophylactically may reduce the incidence of certain post-operative infections in patients undergoing surgical procedures that are classified as contaminated or potentially contaminated or in clean operations where infections would have serious effects.
Protection is best ensured by achieving adequate local tissue concentrations at the time contamination is likely to occur.
Cefotaxime Medo 1 gr         should therefore be administered immediately prior to surgery and if necessary continued in the immediate post-operative period.
Administration should usually be stopped within 24 hours since continuing use of any antibiotic in the majority of surgical procedures does not reduce the incidence of subsequent infection.
BACTERIOLOGY:
The following organisms have shown in vitro sensitivity to Cefotaxime Medo 1 gr.
GRAM POSITIVE:
Staphylococci, including coagulase-positive, coagulase-negative and penicillinase-producing strains.
Beta-haemolytic and other streptococci such as Streptococcus mitis (viridans) (many strains of enterococci, e.g. Streptococcus faecalis, are relatively resistant).
Streptococcus (Diplococcus) pneumoniae.
Clostridium spp.
GRAM NEGATIVE:
Escherichia coli., Haemophilus influenzae including ampicillin-resistant strains.
Klebsiella spp., Proteus spp. (both indole positive and indole negative)., Enterobacter spp., Neisseria spp. (including β-lactamase producing strains of N. gonorrhoea)., Salmonella spp. (including S.
typhi)., Shigella spp., Providencia spp., Serratia spp., Citrobacter spp.


Cefotaxime Medo 1 gr has frequently exhibited useful in vitro activity against Pseudomonas and Bacteroides species although some strains of Bacteroides fragilis are resistant.

There is in vitro evidence of synergy between Cefotaxime Medo 1 gr and aminoglycoside antibiotics such as gentamicin against some species of Gram-negative bacteria including some strains of 

Pseudomonas. No in vitro antagonism has been noted. In severe infections caused by Pseudomonas spp. the addition of an aminoglycoside antibiotic may be indicated.