The in vitro activity of cefotaxime versus bacteria involved in selected infections of hospitalized patients outside of the intensive care unit

Abstract

Cefotaxime, a parenteral third-generation cephalosporin in broad clinical use since the early 1980s, continues to possess extensive in vitro activity versus a variety of bacteria that are frequent causes of selected infections that commonly occur in hospitalized patients. Currently, bacteria with cefotaxime minimum inhibitory concentrations (MICs) of 8̌ μg/ml are considered to be susceptible, and therefore amenable to treatment with cefotaxime at dosages of 2 g intravenously (IV) every 6 or 8 h when causing monomicrobic infections in immunocompetent patients in whom adequate delivery of the drug to site(s) of infection can be assured. In fact, many common bacterial causes of infection typically have cefotaxime MICs 64 to 256-fold lower than the 8 μg/ml break point for susceptible. It is likely that selected monomicrobic infections in immunocompetent hospitalized patients due to such highly susceptible organisms could be treated with lower dosages of cefotaxime or with longer dosing intervals (e.g., I g IV every 8–12 h or 2 g IV every 12 h. Examples of such infections include Gram-negative pneumonia outside of the intensive care unit setting, community-acquired pneumonia, skin and-soft tissue infections, pyelonephritis, and uncomplicated lower urinary tract infections.