A comparison of cefotaxime and cefoperazone in respiratory tract infections

The clinical efficacy and safety of cefotaxime and cefoperazone were evaluated in a comparative study. There were 18 adult males and 11 females. Their underlying disease was pneumonia (10), pleural empyema (2), bronchiectasis (6), bacterial bronchitis (9), lung abscess (2). Bacterial material included sputum, bronchial secretion gained by bronchoscopy or tracheal aspiration, and pleural punctures obtained up to 24 h before treatment. Most patients had Streptococcus pneumoniae or Haemophilus influenzae infections, although two patients in the cefoperazone group had infections caused by Pseudomonas aeruginosa, and another two anaerobic flora. Standard disc diffusion, and agar dilution susceptibilities were performed on all isolates. Patients received either cefoperazone (14) intravenously or intramuscularly in a dose range from 2 to 8 g/day or cefotaxime (15) 1 to 2 g intravenous or intramusculary at dosing intervals of 6 to 8 h (total 3 to 8 g/day), depending on the severity of the disease. Clinical improvement occurred in 14/15 (93%) of patients in the cefotaxime group, and 12/14 (86%) of patients treated with cefoperazone. Two failures in the cefoperazone group were secondary to superinfection (Acinetobacter and Ps. aeruginosa). Bacteriological and symptomatic failure, occurred in one patient with anaerobic lung abscess treated with cefotaxime. The results of this study indicate that cefotaxime is safe and effective in the therapy of acute bacterial lower respiratory tract infections.