Levels of cefotaxime in body fluids and tissues: a review

Cefotaxime is a third-generation cephalosporin with a broad spectrum of activity. Concentrations of cefotaxime in serum and urine are sufficient for clinical efficacy. This report reviews the available data on the penetration of cefotaxime into other body fluids and tissues. Therapeutic doses of cefotaxime result in significant levels in bile (20 micrograms/ml), in cerebrospinal fluid of patients with meningitis (5-10 micrograms/ml), in pleural fluid (2-7 micrograms/ml), and in otitis media exudate (2-10 micrograms/ml). Lower levels of cefotaxime are obtained in uninflamed aqueous humor (1 microgram/ml), in breast milk (0.1-0.5 microgram/ml), and in cerebrospinal fluid of patients without meningitis (0.2 microgram/ml). Cefotaxime levels in tissues are generally well within the range required for clinical efficacy--i.e., 2-5 micrograms/g, with some higher levels reported in testis, prostate, ureter, skin, and gallbladder wall. Drug levels of less than 2 micrograms/g have been reported in fat, muscle, and uterus. All body fluids and tissues, including bone and skin, are penetrated easily by therapeutic doses of cefotaxime.