PMID: 3383550Feb 1, 1988Paper

Optimal cefotaxime dosing for gram-negative bacteremia: effective trough serum bactericidal titers and drug concentrations 8 and 12 hr after 1- or 2-gm infusions

Diagnostic Microbiology and Infectious Disease
H C GoodpastureJ D Peterie

Abstract

Thirteen adult patients (47-81 yr) with gram-negative bacteremia and normal (less than or equal to 1.5 mg/dl) serum creatinines were treated with 1 or 2 gm of cefotaxime every 8 or 12 hr. The infecting organisms were Escherichia coli (9 strains), Klebsiella pneumoniae (2 strains), and one isolate of Salmonella enteritidis and Serratia marcescens. All patients recovered without any serious sequelae. The range of MICs for cefotaxime and desacetyl-cefotaxime were 0.015-0.25 micrograms/ml and 0.015-4.0 micrograms/ml, respectively. The MBC values for cefotaxime and desacetyl-cefotaxime were identical to the MIC values except for two strains. The trough levels of cefotaxime varied from 65.9 to 1.1 micrograms/ml. The serum concentration of desacetyl-cefotaxime varied from 84 to less than 1.0 microgram/ml. All corresponding trough serum inhibitory activities (SIA) were greater than or equal to 1:32. Comparisons of calculated and directly measured serum bactericidal activity (SBA) and SIA results suggest an additive and occasional synergistic benefit of the cefotaxime desacetyl metabolite. This study supports the clinical efficacy and cost-effectiveness of 8- and 12-hr dosing intervals for cefotaxime against bacteremic gram-negative str...Continue Reading

References

Apr 11, 1985·The New England Journal of Medicine·J S Wolfson, M N Swartz
Sep 1, 1984·The Journal of Antimicrobial Chemotherapy·R H Parker, S Park
Sep 1, 1982·Reviews of Infectious Diseases·R N Jones, C Thornsberry
Dec 1, 1983·The Journal of Antimicrobial Chemotherapy·J D Baumgartner, M P Glauser
Sep 1, 1984·The Journal of Antimicrobial Chemotherapy·H C Neu
Nov 1, 1980·Antimicrobial Agents and Chemotherapy·R D PearsonS W Chapman

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Citations

Jan 1, 1989·Diagnostic Microbiology and Infectious Disease·G M TrenholmeG W Parkhurst
May 1, 1995·Diagnostic Microbiology and Infectious Disease·J D Turnidge
May 1, 1995·Diagnostic Microbiology and Infectious Disease·D H Wittmann
Nov 19, 2003·Scandinavian Journal of Infectious Diseases·John Turnidge

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