Cefotaxime is a semisynthetic third-generation cephalosporin antibiotic, which plays an important role in clinical treatment and plays a key role in the fight against bacterial infections. The following is a detailed popular science about cefotaxime:
1. Basic information of cefotaxime 1. Chemical structure and properties: The chemical structure of cefotaxime contains a specific cephalosporin nucleus, which is the key structural basis for its antibacterial effect. Its appearance is white to yellowish crystals or powder, odorless or slightly special odor. It is soluble in water and slightly soluble in ethanol. This physical property makes it have better solubility and stability in the preparation and use process, and is convenient to be prepared into various dosage forms for clinical use. 2. Preparation specification: Cefotaxime is generally made into injection (powder). Drug effects and adverse reactions of preparations from different manufacturers may be different due to different manufacturing processes. Common specifications are 0.5 grams, 1.0 grams, 2.0 grams and so on.
2. Antibacterial mechanism of cefotaxime The antibacterial mechanism of cefotaxime is mainly to inhibit the synthesis of bacterial cell wall to play a bactericidal role. The cell wall of bacteria is very important to maintain the morphology and survival of bacteria, and cefotaxime can bind to specific targets on the bacterial cell wall, inhibit the activity of cell wall mucopeptide synthetase, and prevent the synthesis of bacterial cell wall mucopeptide, so that bacteria lose the protection of the cell wall, expand and crack under the action of internal osmotic pressure, and eventually lead to bacterial death. In addition, cefotaxime has a high stability to β-lactamase, which makes it effective against some resistant strains that can produce β-lactamase, expanding its antibacterial spectrum and clinical application.
3. Antimicrobial spectrum of cefotaxime Cefotaxime is a broad-spectrum antibiotic, which has a strong antibacterial effect on a variety of Gram-positive and Gram-negative bacteria. • Effect on Gram-positive bacteria: It has certain antibacterial activity against common Gram-positive bacteria such as Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes, but its antibacterial effect on Gram-positive bacteria is weaker than that of first-generation and second-generation cephalosporin antibiotics. However, for some penicillin-resistant Gram-positive infections, cefotaxime may still have some therapeutic effect. • Effect on Gram-negative bacteria: This is the advantage of cefotaxime, which has a strong bactericidal effect on Gram-negative bacteria such as Escherichia coli, Klebsiella, Enterobacter, Proteus, Salmonella and Shigella. Cefotaxime also has strong antibacterial activity, especially for some Gram-negative bacteria which are easy to cause serious infections, such as Pseudomonas aeruginosa and Acinetobacter.
4. Clinical application of cefotaxime 1. Treatment of infectious diseases: • Respiratory tract infections: including pneumonia, bronchitis, tonsillitis, pharyngolaryngitis, etc. Cefotaxime can play a good role in the treatment of both community-acquired and hospital-acquired respiratory tract infections. For example, for pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, etc., cefotaxime is one of the commonly used therapeutic drugs. • Urinary tract infection: such as cystitis, urethritis, pyelonephritis, etc. Because cefotaxime can maintain a high concentration in urine, it has a significant therapeutic effect on urinary tract infections. Cefotaxime is also often used as one of the first choice drugs for complicated urinary tract infections or recurrent urinary tract infections. • Abdominal infection: such as peritonitis, cholecystitis, appendicitis, etc. Intra-abdominal infection is usually caused by mixed infection of multiple bacteria. Cefotaxime has good antibacterial effect on common pathogens of intra-abdominal infection and can effectively control infection. • Central nervous system infection: Under certain conditions, cefotaxime can penetrate the blood-brain barrier and enter the central nervous system, so it also has a certain therapeutic effect on meningitis, brain abscess and other central nervous system infections. However, the dosage and mode of administration need to be adjusted according to the specific conditions of patients. • Other infections: It can also be used to treat serious infectious diseases such as bone and joint infections, skin and soft tissue infections, and septicemia. 2. Surgical prevention of infection: In order to prevent postoperative infection during some major operations or clean-contaminated operations, doctors may give patients cefotaxime before or during the operation. For example, in abdominal surgery, orthopedic surgery, cardiothoracic surgery and other operations, the prophylactic use of cefotaxime can effectively reduce the incidence of postoperative infection.
5. Precautions for using cefotaxime 1. Adverse reactions: • Common adverse reactions: After using cefotaxime, allergic reactions such as rash, drug fever and phlebitis may occur; gastrointestinal reactions such as diarrhea, nausea, vomiting and loss of appetite may also occur; Some patients may have laboratory abnormalities such as mild elevation of alkaline phosphatase or serum aminotransferase, transient elevation of blood BUN and creatinine.
