GlobalRPh Renal Dosing Masterv6.6
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Cefotaxime

Local official-label summaryBase record retrieved 2026-09-05See the evidence for this drug3 sources available - open source summaries, references and comparisons
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Official source

Cefotaxime for injection, USP

Product / population
Adult IV/IM cefotaxime sodium; not ceftriaxone.
Renal measure
Not specified; verify before use
Baseline adult infection doses

Uncomplicated infection: 1 g every 12 hours IM/IV. Moderate/severe infection: 1-2 g every 8 hours IM/IV. Higher-dose infections such as septicemia: 2 g IV every 6-8 hours. Life-threatening infection: 2 g IV every 4 hours; maximum 12 g/day.

Renal adjustment and method caution

The label suggests halving the dose below estimated CrCl 20 mL/min/1.73 m2. It also presents the Cockcroft-Gault formula and requires steady-state serum creatinine. Preserve this indexed threshold as written; do not assume an unindexed estimate and indexed value are numerically identical. Individualize for infection severity and clinical course.

Source revision: | Retrieved: 2026-09-05. Retrieval date is not the revision date.

Source: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ed23b6bc-32c7-4c50-a53d-313ae78e5623

Scope: Source-read local summary; source-specific recommendations are not automatically interchangeable. GlobalRPh v6.6.

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Evidence sources and renal implications

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Preserved original GlobalRPh source

Preserved historical content; not revalidated as current prescribing guidance.

Renal method: Read the measure and population stated in the original source sections.
Retrieved: 2026-09-05

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Handbook

Renal Drug Handbook, fifth edition

Historical 2019 reference; renal bands retain the book's own method labels.

Renal method: See source.
Retrieved: 2026-09-05

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Original content / product scopeCefotaxime for injection, USPRenal Drug Handbook, fifth edition
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Historical source content is not a current prescription. Original GlobalRPh recommendations are preserved, not automatically certified as current. Product-label and professional additions below are separately attributed. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.

Important source distinctions

The source phrase most recent refers to November 2012. This historical source has not been relabeled as current FDA or Stanford guidance.

Current-source disagreement: the selected U.S. label suggests dose reduction below an indexed CrCl of 20; the older handbook table reduces below 5. Both are attributed below; this is not a single reconciled threshold.

Locally stored source content

Original GlobalRPh protocol

Clinical facts and comments transcribed into a structured reading format. This is not a byte-for-byte HTML archive. Original source: https://globalrph.com/renal/cefotaxime/

Usual Dosing (Adults)

Uncomplicated infections: 1 gram IV/IM every 12 hours. Moderate to severe: 1 to 2 grams IV/IM every 8 hours. Severe: 2 grams IV every 6 to 8 hours. Life-threatening: 2 grams IV every 4 hours.

CLAFORAN source dosing table:

InfectionDaily doseDose and route
Gonococcal urethritis/cervicitis in males and femalesSingle dose0.5 g IM once
Rectal gonorrhea in femalesSingle dose0.5 g IM once
Rectal gonorrhea in malesSingle dose1 g IM once
Uncomplicated infections2 g1 g every 12 hours IM or IV
Moderate to severe infections3 to 6 g1 to 2 g every 8 hours IM or IV
Infections commonly needing higher dosage, e.g. septicemia6 to 8 g2 g every 6 to 8 hours IV
Life-threatening infectionsUp to 12 g2 g every 4 hours IV

If Chlamydia trachomatis is suspected, add appropriate coverage because cefotaxime has no activity against this organism.

Surgical prophylaxis in contaminated or potentially contaminated surgery: 1 g IM or IV 30 to 90 minutes before surgery. Cesarean section: 1 g IV as soon as the umbilical cord is clamped, followed by 1 g IV or IM 6 and 12 hours after the first dose.

Neonates: 0 to 1 week, 50 mg/kg/dose IV every 12 hours; 1 to 4 weeks, 50 mg/kg/dose IV every 8 hours. The source states that it is not necessary to differentiate premature and normal-gestational-age infants.

Children 1 month through 12 years weighing <50 kg: 50 to 180 mg/kg/day IM or IV in 4 to 6 equal doses; use higher doses in more severe infections including meningitis. At >=50 kg, use adult dosing; maximum 12 g/day.

GRPH-cefotaxime-01 · Source section: Usual Dosing (Adults)Renal section finder

Renal Dosing

Dosing recommendations for this drug in renal impairment have changed over the years. Here is the most recent comments from the package insert (Nov 2012):

Because high and prolonged serum antibiotic concentrations can occur from usual doses in patients with transient or persistent reduction of urinary output because of renal insufficiency, the total daily dosage should be reduced when CLAFORAN is administered to such patients.

Continued dosage should be determined by degree of renal impairment, severity of infection, and susceptibility of the causative organism. Although there is no clinical evidence supporting the necessity of changing the dosage of cefotaxime sodium in patients with even profound renal dysfunction, it is suggested that, until further data are obtained, the dose of cefotaxime sodium be halved in patients with estimated creatinine clearances of <20 mL/min/1.73 m2.

Note: earlier guidelines recommended interval extension, however, the newer guidelines do not mention interval changes ... just dosage reduction.

GRPH-cefotaxime-02 · Source section: Renal DosingRenal section finder

Hemodialysis

No specific guidance available per package insert except for what is listed above. Previous guidelines: Hemodialysis: 500 mg to 2 g every 24 hours, plus give a supplemental dose post-dialysis.

GRPH-cefotaxime-03 · Source section: HemodialysisRenal section finder
Separate U.S. product-label layer

FDA / DailyMed dosing and renal information

Official

Cefotaxime for injection, USP

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NIH/NLM DailyMed - U.S. prescribing information · Adult IV/IM cefotaxime sodium; not ceftriaxone.

Renal method: Not specified in this summary.
Source date:
Retrieved: 2026-09-05

Source-read local summary; source-specific recommendations are not automatically interchangeable.

Baseline adult infection doses

Uncomplicated infection: 1 g every 12 hours IM/IV. Moderate/severe infection: 1-2 g every 8 hours IM/IV. Higher-dose infections such as septicemia: 2 g IV every 6-8 hours. Life-threatening infection: 2 g IV every 4 hours; maximum 12 g/day.

cefotaxime:dm-ed23b6bc-32c7-4c50-a53d-313ae78e5623-1 · Source locator: Dosage and Administration: adult guideline table

Renal adjustment and method caution

The label suggests halving the dose below estimated CrCl 20 mL/min/1.73 m2. It also presents the Cockcroft-Gault formula and requires steady-state serum creatinine. Preserve this indexed threshold as written; do not assume an unindexed estimate and indexed value are numerically identical. Individualize for infection severity and clinical course.

cefotaxime:dm-ed23b6bc-32c7-4c50-a53d-313ae78e5623-2 · Source locator: Precautions: General

Source identity and provenance
Source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ed23b6bc-32c7-4c50-a53d-313ae78e5623
Retrieved
2026-09-05
Exact label title
Cefotaxime for injection, USP
DailyMed Set ID
ed23b6bc-32c7-4c50-a53d-313ae78e5623
Labeler
Hikma Pharmaceuticals USA Inc.
DailyMed page updated
2024-04-11
FDA application
Abbreviated New Drug Application
U.S. product identity basis
Exact named product and route appear in the selected U.S. prescription label; current retail availability was not independently assessed.
Hash meaning
Locally authored source summary, not original SPL/XML/PDF bytes
Local summary SHA-256
ad3a73753cd3b96cff0af18a590cd1d1ea21dc8e2b0ddccfc7dd6b4e083b6afc
Separate handbook layer

Renal Drug Handbook cross-check

Handbook

Renal Drug Handbook, fifth edition

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UK Renal Pharmacy Group / Ashley and Dunleavy / CRC Press · Historical 2019 reference; renal bands retain the book's own method labels.

Renal method: Not specified in this summary.
Source date: Not established
Retrieved: 2026-09-05

Historical handbook facts locally summarized; not a current U.S. label or a modern CRRT protocol.

Historical renal protocol and conflict

The handbook retains the selected usual dose in its 20-50 and 5-20 mL/min bands and halves the dose, without changing frequency, only below 5. This differs materially from the selected U.S. label's below-20 threshold. Do not merge the two cutoffs.

cefotaxime:rdh5-180-1 · Source locator: Dose in renal impairment

Historical replacement therapy

APD/CAPD is described as not dialysing cefotaxime; HD and high-flux treatment do, with the book referring to the <5 band. Its older continuous-therapy rows list 1-2 g every 12 hours for CAV/VVHD and 2 g every 12 hours for CVVHD/HDF. These lack a contemporary effluent-rate-specific validation.

cefotaxime:rdh5-180-2 · Source locator: Dose in patients undergoing renal replacement therapies

Source-specific limits

The book's separate fluid-flux discussion has not been implemented as a clearance calculator. The U.S. label and handbook disagreement is unresolved, not counted as corroboration.

Source identity and provenance
Retrieved
2026-09-05
Handbook page
Printed page 180; PDF page 199
Hash meaning
Locally authored source summary, not original SPL/XML/PDF bytes
Local summary SHA-256
ea9c665679f6a80ef6ed048867bdbd7064691ce67ecf9cbf7dd8ecffd67e344b

Provenance and preservation

Additional summaries stored on this page: 1 official-label, 0 RX List, 0 professional, 1 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://globalrph.com/renal/cefotaxime/
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
globalrph individual
Local text SHA-256
3df850bde5078006802b6df9275e4e25d379b130203f64f4eae3bb203e22bd9a
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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