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Cefotaxime: clinical and bacteriologic evaluation.

G Saroglou, O Paniara-Volika, A Sima

    Clinical Therapeutics
    |January 1, 1981
    PubMed
    Summary
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    Cefotaxime shows strong activity against cephalothin-resistant Enterobacteriaceae but limited efficacy against Pseudomonas species. This new cephalosporin proved effective in treating patient infections, with few resistant bacteria emerging.

    Area of Science:

    • Clinical Microbiology
    • Infectious Diseases
    • Pharmacology

    Background:

    • Beta-lactamase-resistant cephalosporins are crucial for treating bacterial infections.
    • Emergence of cephalothin-resistant bacteria necessitates evaluation of newer agents.
    • Enterobacteriaceae and Pseudomonas species are common causes of hospital-acquired infections.

    Purpose of the Study:

    • To evaluate the in vitro activity of cefotaxime against cephalothin-resistant Gram-negative bacteria.
    • To compare cefotaxime's efficacy with cefazolin and cefuroxime.
    • To assess cefotaxime's clinical effectiveness in hospitalized patients.

    Main Methods:

    • In vitro susceptibility testing of cefotaxime, cefazolin, and cefuroxime against 78 clinical isolates.
    • Clinical evaluation of cefotaxime in 23 hospitalized patients with various infections.

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  • Detection of beta-lactamases in cefotaxime-resistant isolates.

    • Main Results:

    • Cefotaxime demonstrated significantly greater activity than cefazolin and cefuroxime against cephalothin-resistant Enterobacteriaceae.
    • Most cephalothin-resistant strains were also resistant to cefazolin.
    • Cefotaxime exhibited limited antipseudomonal activity. Clinical use in 23 patients resulted in one failure and two colonizations with resistant strains.

    Conclusions:

    • Cefotaxime is a potent agent against many cephalothin-resistant Enterobacteriaceae.
    • Its activity against Pseudomonas species is restricted.
    • Emergence of cefotaxime resistance was linked to specific cephalosporinases and beta-lactamases.