ALB and uremia: Cefotaxime can induce central nervous system effects through several mechanisms: prolonged serum half-life in patients with reduced kidney function, resulting in increased blood concentrations; enhanced blood-brain barrier permeability in uremia, which may lead to an imbalance in central nervous system neurotransmitters and trigger neurological symptoms[19]; and decreased binding of cefotaxime (with protein binding of 30–50%) to albumin.