Influence of cefotaxime on renal function during the treatment of infections

A study was conducted of the effects of cefotaxime, a third generation cephalosporin antibiotic, on the function of the kidney, using several indices of renal function including urinary concentrations of the renal enzyme N-acetyl-beta-D-glucosaminidase (NAG). In 6 patients with respiratory infections and normal renal function (group I), the urinary concentrations of NAG before and after the administration of cefotaxime 2 to 4g daily were 5.7 +/- 0.6 U/L and 5.5 +/- 0.9 U/L, respectively (NS). Similarly, 9 patients with chronic renal failure who were not undergoing haemodialysis showed pre- and post-treatment urinary NAG concentrations of 8.7 +/- 4.0 U/L and 6.6 +/- 1.7 U/L, respectively (NS), while the corresponding values in 12 renally impaired patients undergoing haemodialysis (group III) were 8.1 +/- 3.5 U/L and 8.9 +/- 3.8 U/L, respectively (NS). With regard to other parameters of renal function (serum creatinine, BUN, beta 2M, and creatinine clearance), no statistically significant differences were found between the values obtained before and after therapy with cefotaxime. Therefore, it was concluded that the influence of cefotaxime on renal function is slight, and that this antibiotic can be safely used to treat patients with infections in the presence of renal dysfunction.