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[Cefotaxime and Gram-negative infections in children. Effectiveness and tolerance (author's transl)]
Insights
Cefotaxime demonstrated high clinical effectiveness in pediatric patients with severe infections, including sepsis and respiratory tract infections. This antibiotic showed good tolerance, even in newborns, and proved effective against Gram-negative bacilli.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Bacteriology
Context:
- Severe bacterial infections in children pose significant treatment challenges.
- Cefotaxime, a third-generation cephalosporin, offers broad-spectrum activity against Gram-negative bacilli.
- Understanding its efficacy and safety in pediatric populations is crucial for clinical practice.
Purpose:
- To evaluate the clinical efficacy and tolerance of cefotaxime in pediatric patients with various severe infections.
- To correlate treatment outcomes with in vitro susceptibility and serum antibiotic concentrations.
- To assess the safety profile of cefotaxime, particularly in neonates.
Summary:
- Twenty-six pediatric patients (15 days to 14 years) with sepsis, respiratory tract infections, urinary tract infections, or otitis media with renal failure received cefotaxime (50-100 mg/kg/day).
- Cefotaxime was administered intramuscularly or intravenously, often in combination with aminoglycosides (gentamicin or amikacin).
- Clinical, radiological, and bacteriological criteria, alongside serum levels, were used for evaluation, with 25 out of 26 patients showing clinical effectiveness.
Impact:
- Cefotaxime is highly effective and well-tolerated in pediatric patients, including newborns.
- Its efficacy correlates with favorable in vitro results and achievable serum concentrations.
- Cefotaxime represents a valuable therapeutic option due to its potent activity against Gram-negative bacilli.
Abstract:
Twenty-six children, aged from 15 days to 14 years, were treated with cefotaxime. 5 were suffering from septicaemia, 14 from respiratory tract infection and were ventilated (intensive care unit), 4 from urinary tract infection and 3 from otitis media complicated with renal failure (nephrology unit). The choice of cefotaxime treatment was based upon the bacterial activity. The daily dose was 50 to 100 mg/kg by the i.m. route, or by slow intravenous injection every 8 hours. In 17 patients, cefotaxime was combined with an aminoglycoside (gentamicin or amikacin). The results were evaluated on the basis of clinical, radiological and bacteriological criteria and, whenever possible, were correlated to the serum levels of antibiotic. The antibiotic was clinically effective in 25 out of 26 patients. The three deaths that occurred, were due to the nature of the initial disease. Tolerance was good in all the patients studied. The efficacy of cefotaxime correlated well with the favorable in vitro bacteriological results and with serum concentrations. Cefotaxime is well tolerated as shown in newborn babies. Cefotaxime is markedly different from previous cephalosporins, because of its high antibacterial activity on most Gram-negative bacilli.