Cefotaxime: United Kingdom clinical trial results in the treatment of severe infections

A multicentre study was carried out to assess the efficacy and tolerance of the wide-spectrum cephalosporin, cefotaxime, in the treatment of 411 hospitalized patients, most of whom were seriously ill with severe infections, including septicaemia, lower respiratory tract infection, urinary tract infections and soft tissue infection. Almost half the patients had failed to respond to previous antibacterial therapy and, in general, prognoses were poor. Patients received cefotaxime by intramusclar or/and intravenous injection in unit doses ranging from 0.5 to 2.0 g, 6 to 12 hourly, for periods up to 10 days or more. The results of clinical response in those who could be assessed showed a cure rate of 75% in 103 patients with septicaemia and over 80% in all other conditions.The bacteriological findings after treatment showed a similarly high eradication rate in a wide range of pathogens, particularly so in infections caused by E. coli, Klebsiella, H. influenzae, Proteus, Staph, aureus, staph. epidermis and Strep. pneumoniae. Useful clinical activity was also demonstrated in infections caused by moderately sensitive pathogens such a Pseudomonas and Strep. faecalis. Cefotaxime was well tolerated by the majority of patients, the commonest side-effects reported being moderate pain of short duration or phlebitis on injection, rash and diarrhoea, as with other cephalosporins. It is concluded that cefotaxime should be considered as a first line antibiotic for patients with severe infections caused by susceptible pathogens.