Cefotaxime: In vitro activity against cephalothin-resistant isolates and use in the treatment of septicemia, pneumonia, urinary tract and other severe infections

Abstract

Susceptibility to cefotaxime of 604 cephalothin-resistant strains was tested with the agar diffusion technique. Compared to cefamandole, cefoxitin and cefuroxime, cefotaxime proved to be the most effective agent againstEnterobacteriaceae. Seventy patients suffering from acute urinary tract infections, septicemia, pneumonia and other severe infections were treated with cefotaxime. The doses were 2–12 g per day, depending on renal function and type of infection. In complicated urinary tract infection (UTI) cure was observed in 20 of 28 patients; failure occurred in eight patients. In uncomplicated acute UTI, all 15 patients responded satisfactorily. Of 14 patients with septicemia eight were cured. Of the remaining 13 patients with severe infections, eight were cured.In vitro susceptible organisms which could neither be eliminated nor which emerged again during treatment were:Staphylococcus aureus (3),Escherichia coli (3),Klebsiella sp. (1),Enterobacter sp. (2),Serratia sp. (3),Proteus mirabilis (2),Achromobacter sp. (1) andPseudomonas aeruginosa (9). Adverse side-effects recorded were skin reactions such as itching exanthem or urticaria in eight of 70 patients. In two patients mild thrombocytopenia, in one patient reversible granulocytopenia and in two patients an increase in liver enzymes was observed. One patient developed diarrhea.