Cefotaxime twice daily versus ceftriaxone once daily. A randomized controlled study in patients with serious...

We randomized 365 patients with serious infections to treatment with either 2 g intravenously (IV) cefotaxime every 12 h or 2 g IV ceftriaxone once daily. Clinical response rates were similar in both treatment groups, with success defined as satisfactory or improved response in 107 of 124 (86.3%) evaluable patients in the cefotaxime group compared with 103 of 114 (90.4%) evaluable patients in the ceftriaxone group. Bacteriologic cure rates were also similar in the two groups (86.4%) in the cefotaxime group compared with 87.0% in the ceftriaxone group). There was no statistically significant difference in the incidence of drug-related adverse events in the two groups. These results indicate that 2 g cefotaxime twice daily is as effective, both clinically and bacteriologically, as 2 g ceftriaxone once daily in serious infections caused by susceptible pathogens.