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Ceftriaxone in the treatment of serious infections, particularly after surgery
Abstract:
The clinical efficacy and safety of ceftriaxone when administered twice daily was evaluated in the treatment of serious infections, including 9 episodes of bacteremia, 4 of pneumonia, 7 of intra-abdominal or soft tissue infections, 11 of urinary tract infections, 3 of osteomyelitis, and 5 of meningitis. Causative pathogens were Strep. pneumoniae, other hemolytic streptococci, E. coli, P. mirabilis, K. pneumoniae, and species of Enterobacter, Serratia, and Pseudomonas. The overall clinical cure rate was 87 percent and the bacteriologic cure rate was 77 percent. Cures were achieved in infections due to organisms resistant to ampicillin, cefazolin, cefamandole, carbenicillin, and gentamicin. Peak plasma levels were far in excess of the minimal inhibitory concentrations of Enterobacteriaceae. Adverse effects were infrequent, and in only one instance was it necessary to discontinue treatment. Resistance to ceftriaxone developed during therapy with several Enterobacter and Pseudomonas species isolates. Ceftriaxone appears to be a useful agent for treatment of serious gram-negative infections in seriously ill patients.
Insights
Ceftriaxone, administered twice daily, demonstrated significant clinical and bacteriologic cure rates in serious infections, including those resistant to other antibiotics. This cephalosporin shows promise for treating severe gram-negative bacterial infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- Serious bacterial infections pose significant treatment challenges.
- The emergence of antibiotic resistance necessitates evaluation of alternative therapeutic agents.
- Ceftriaxone is a third-generation cephalosporin with broad-spectrum activity.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of ceftriaxone administered twice daily.
- To assess ceftriaxone's effectiveness against a range of serious infections and pathogens.
- To compare ceftriaxone's activity against resistant bacterial strains.
Main Methods:
- A clinical study evaluated ceftriaxone in patients with serious infections.
- Infections included bacteremia, pneumonia, intra-abdominal, soft tissue, urinary tract, osteomyelitis, and meningitis.
- Causative pathogens included Gram-positive and Gram-negative bacteria, with susceptibility testing performed.
Main Results:
- Overall clinical cure rate was 87%, with a 77% bacteriologic cure rate.
- Effective treatment was observed in infections caused by bacteria resistant to ampicillin, cefazolin, cefamandole, carbenicillin, and gentamicin.
- Adverse effects were infrequent, with only one case requiring treatment discontinuation.
Conclusions:
- Ceftriaxone demonstrates high clinical and bacteriologic efficacy in treating serious infections.
- It is effective against pathogens resistant to multiple other antibiotics, including common Gram-negative species.
- Ceftriaxone is a valuable therapeutic option for serious gram-negative infections in critically ill patients.