cefotetan

Cefotetan is a second-generation cephalosporin antibiotic in the cephamycin subgroup. It shares the beta-lactam mechanism of action with other cephalosporins, inhibiting bacterial cell wall synthesis by binding to penicillin-binding proteins, and thereby exerting bactericidal activity. A characteristic thio-tetrazolyl side chain gives cefotetan a distinct pharmacologic profile and contributes to certain adverse effects.

The antibiotic has broad activity against many Gram-positive cocci and several Gram-negative rods, with additional activity against anaerobes such as Bacteroides fragilis, a trait of cephamycins. It is not active against Pseudomonas aeruginosa and should be used with consideration of local resistance patterns. Cefotetan is administered parenterally, usually by intravenous or intramuscular injection, and is distributed into most body tissues with limited penetration into the central nervous system unless meninges are inflamed.

Pharmacokinetically, cefotetan is primarily excreted renally and requires dose adjustment in renal impairment. It has a relatively short to moderate half-life in individuals with normal renal function and is typically given every 12 hours, depending on infection type and severity.

Adverse effects include hypersensitivity reactions, rash, and gastrointestinal symptoms. The methylthio-tetrazole side chain can cause a disulfiram-like reaction with alcohol consumption and may contribute to hypoprothrombinemia, particularly in patients taking anticoagulants or with low vitamin K intake. Contraindications include hypersensitivity to cephalosporins or penicillins.