Seventy-seven patients with acute
bacterial infections were treated with
ceftriaxone (1 gm administered intravenously every 12 hours). The 58 patients evaluable for efficacy had 60
infections, including 39 of the respiratory tract, 14 of the urinary tract, and seven of soft tissue. Five patients were bacteremic. The mean duration of
ceftriaxone treatment was eight days for patients with respiratory and
urinary tract infections and 13 days for patients with other types of
infections. A satisfactory clinical response occurred in 56 (93%) of the
infections. Eighty-four (94%) of the 89 pretherapy pathogens were bacteriologically eradicated. Included were all 19 isolates of Haemophilus influenzae, all 15 of Streptococcus pneumoniae, all 12 of Escherichia coli, 22 of the 23 isolates of other Enterobacteriaceae species, three of five isolates of Pseudomonas aeruginosa, and three of four isolates of Staphylococcus aureus. Two cases of
superinfection (one with
bacteremia) occurred with P aeruginosa. There were two cases each of
reinfection and colonization with Streptococcus faecalis. One patient developed manifestations of culture-documented S pneumoniae
meningitis eight hours after the first dose was administered. Peak and trough plasma levels of
ceftriaxone were 142 and 64 micrograms/ml.
Ceftriaxone achieved therapeutic levels in infected cerebrospinal fluid and in the
abscess fluid of selected patients. Adverse effects, which were mild, included
diarrhea in 4% of the patients and elevated
transaminase levels in 10%.