title: Once-daily therapy with ceftriaxone compared with daily multiple-dose therapy with cefotaxime for serious bacterial infections: a randomized, double-blind study.
abstract: A randomized, double-blind study was done to compare the efficacy and toxicity of daily single-dose therapy with intravenous ceftriaxone (2 g every 24 h) with daily multiple-dose therapy with cefotaxime (2 g every 6 h) for treatment of serious bacterial infections in nonneutropenic patients. Of the 325 patients who were evaluable for toxicity, 241 (74.2%) were evaluable for efficacy. Infection sites included lung (106), urinary tract (42), skin and soft tissue (43), bone and joint (23), bacteremia (21), and hepatobiliary (5). Definite infections were present in 173 cases (71.8%) and possible infections in 68 (28.2%). Analysis of clinical and bacteriologic responses and adverse drug reactions showed no significant differences between the regimens. Values for 95% confidence limits on the differences between regimens for positive clinical and bacteriological outcomes in definite infections were -0.8% to 3.0% and -1.9% to 9.1%, respectively. Thus, daily single-dose therapy with ceftriaxone was comparable to daily multiple-dose therapy with cefotaxime in treating these bacterial infections.
authors.affiliation: McMaster University, Division of Infectious Diseases, Hamilton, University of Ottawa, Canada.
authors.forename: L A
authors.initials: LA
authors.lastname: Mandell
authors.forename: M G
authors.initials: MG
authors.lastname: Bergeron
authors.forename: A R
authors.initials: AR
authors.lastname: Ronald
authors.forename: C
authors.initials: C
authors.lastname: Vega
authors.forename: G
authors.initials: G
authors.lastname: Harding
authors.forename: R
authors.initials: R
authors.lastname: Saginur
authors.forename: R
authors.initials: R
authors.lastname: Feld
authors.forename: R
authors.initials: R
authors.lastname: Duperval
authors.forename: S J
authors.initials: SJ
authors.lastname: Landis
authors.forename: L J
authors.initials: LJ
authors.lastname: Miedzinski
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000188:drug therapy*; D002439:Cefotaxime / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011897:Random Allocation
chemical_list: D002443:Ceftriaxone; D002439:Cefotaxime