The efficacy of
cefotaxime sodium for treatment of patients with lower
respiratory infections was evaluated by three protocols in multicenter trials. The first trial studied
cefotaxime alone; the second and third trials compared
cefotaxime with
cefazolin in observer-blind and single-blind randomized controlled studies, respectively. A total of 656 patients were entered in the three trials; 527 received
cefotaxime. Overall rates of bacteriologic and clinical cure, analyzed by pathogen, for the
cefotaxime treated patients were 89.9% and 93.9%, respectively. In the two comparative trials, overall rates of bacteriologic and clinical cure with
cefotaxime, by pathogen, were greater than 94% and numerically exceeded those for
cefazolin in each instance. The efficacies in the comparative studies, when analyzed by total patient responses, were significantly different only for clinical responses to
cefotaxime in the single-blind randomized trial (P = 0.03). Favorable cure rates with
cefotaxime were obtained in patients with
infections due to Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes, Staphylococcus aureus, and Escherichia coli, and nearly comparable responses were obtained for
infections due to Proteus, Enterobacter, and Klebsiella species.
Cefotaxime was clinically effective in some of the
infections due to Serratia marcescens and Pseudomonas aeruginosa, but bacteriologic failures occurred in 67% and 61% of cases, respectively. All Serratia strains were highly susceptible in vitro to
cefotaxime, but the range of minimal inhibitory concentrations of
cefotaxime for Pseudomonas isolates was wide.