title: Clinical experience with cefotaxime for the therapy of bacteremias due to gram-positive organisms.
abstract: Fifty-five patients with gram-positive bacteremias were treated with cefotaxime after enrollment in comparative and non-comparative study protocols. Forty-nine of these 55 patients were evaluable and followed for their response to therapy and adverse effects. Most patients were white males 50 years of age or older (69%); 45% had two or more serious underlying diseases. Pneumonias caused 59% of these bacteremias, which were etiologically due to Streptococcus pneumoniae (22 episodes), Staphylococcus aureus (15), coagulase-negative staphylococci (3) and other streptococci (12). Overall, 90% of bacteremias were cured with cefotaxime therapy. Among five treatment failures were included three deaths, one due to cefotaxime-associated pseudomembranous colitis, one caused by a bacteremic superinfection due to Pseudomonas aeruginosa and one due to a progressive pneumonia despite therapy. Adverse effects of therapy were infrequent and noteworthy for only one patient with questionable nephrotoxicity and a lack of cefotaxime-associated coagulopathy.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002439:Cefotaxime / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018805:Sepsis / Q000188:drug therapy*
chemical_list: D002439:Cefotaxime