Cefotaxime is used for infections of the respiratory tract, skin, bones, joints, urogenital system, meninges, and bloodstream. It generally has good coverage against most Gram-negative bacteria, with the notable exception of Pseudomonas. It is also effective against most Gram-positive cocci except for Enterococcus. It is active against penicillin-resistant strains of Streptococcus pneumoniae. It has modest activity against the anaerobic Bacteroides fragilis. In meningitis, cefotaxime crosses the blood–brain barrier better than cefuroxime.
Cefotaxime is a cephalosporin, which acts by interference of synthesis of peptidoglycan of the bacterial cell wall. Cefotaxime, a cephalosporin antibiotic, is active against both gram-negative and gram-positive bacteria. In addition, cefotaxime blocks the division of cyanobacteria and lower plant organelles/plastids such as the photosynthetic organelles of Glaucophytes and chloroplasts of bryophytes.
Cefotaxim inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls. As a result, bacteria lyse due to cell wall autolytic enzymes.