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[Microbiologic and clinical significance of cefotiam]
Abstract:
Modern cephalosporins are of considerable importance for the therapy of severe infections by multiresistant organisms. According to in-vitro-findings on ampicillin-resistant E. coli as well as Klebsiella spp., Proteus spp., and serratia spp., altogether 159 strains, instead of cefotaxime nearly always also cefotiam can be used. The two remedies are clearly superior to cephalothin. cefotiam is ineffective to Pseudomonas aeruginosa. But in this case also cefotaxime is clearly inferior to azlocillin. In 6 of 7 casuistic instances the clinical effectiveness of cefotiam could be confirmed with good tolerability. The contemporary establishment of staph. aureus in mixed infections of serratiastaphylococci proved as as particular advantage. A primary therapeutic failure referred to a necrotizing pancreatitis, when no causative organism was proved, in which case also cefotaxime remained without any effect. Despite the improved individual medical possibilities the control of the infectious hospitalism by critical administration of antibiotics and improved hospital hygiene, particularly strict non-infection, must remain the pre-eminent task.
Insights
Modern cephalosporins like cefotaxime and cefotiam are effective against many resistant bacteria, outperforming older drugs. Cefotiam shows clinical success, but azlocillin is better for Pseudomonas aeruginosa infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Severe infections caused by multiresistant organisms necessitate effective antibiotic therapies.
- Modern cephalosporins play a crucial role in treating such infections.
Observation:
- In vitro studies evaluated 159 strains of ampicillin-resistant E. coli, Klebsiella spp., Proteus spp., and Serratia spp.
- Cefotaxime and cefotiam demonstrated significant efficacy, surpassing cephalothin.
- Cefotiam was ineffective against Pseudomonas aeruginosa, where azlocillin proved superior.
Findings:
- Cefotiam exhibited clinical effectiveness with good tolerability in 6 out of 7 cases.
- Its use in mixed Serratia-Staphylococci infections was particularly advantageous.
- A case of necrotizing pancreatitis without a proven organism showed no response to cefotaxime or cefotiam.
Implications:
- Cefotiam offers a viable therapeutic option for specific resistant bacterial infections.
- Judicious antibiotic use and stringent hospital hygiene remain paramount in controlling hospital-acquired infections.
- Further research into optimal cephalosporin application against complex resistant pathogens is warranted.