Cefotaxime treatment of skin and skin structure infections: a multicenter study

The efficacy, safety, and tolerability of cefotaxime, a new parenteral cephalosporin resistant to beta-lactamase, were evaluated in a multicenter open trial. The study population comprised 594 hospitalized patients with infections of the skin or subcutaneous tissue. Of these, 409 patients fulfilled the protocol requirements for assessment of clinical efficacy. Usual dosages of cefotaxime were in the range of 1.5 to 12 gm/day for 5 to 85 days. Staphylococcus aureus was the most frequent gram-positive organism; Proteus mirabilis, Escherichia coli, and Pseudomonas aeruginosa, the most frequent gram-negative bacilli; and Peptococcus sp, the most frequent anaerobic organism isolated. Of the 409 evaluable patients, 382 (93.4%) were clinically cured. Bacteriological cures were obtained in 316 of 372 (84.9%) patients. Reactions to cefotaxime included asymptomatic eosinophilia, rash, drug fever, phlebitis, and elevated hepatic enzyme levels. All reactions were transient, and drug therapy had to be terminated in only eight patients. Cefotaxime proved effective for treating a variety of skin and soft tissue infections. The lack of serious toxicity and adverse reactions associated with cefotaxime, together with its broad antimicrobial spectrum, makes it a suitable substitute for aminoglycosides in certain clinical settings.