Cefotaxime is a new semisynthetic cephalosporin displaying high antibacterial activity against grampositive, gram-negative and anaerobic organisms. It acts bactericidally and is stable against betalactamases. The authors investigated the usefulness of cefotaxime in the treatment of infections in mature and premature infants and the following results were obtained; The half-life of cefotaxime after i. v. administration in mature and premature infants was inversely related to age, and tended to be longer in the former than the latter although there were pronounced intersubject differences. The pharmacokinetics of cefotaxime after i. v. injection of 10 mg/kg and 20 mg/kg was dose-related. The half-life of cefotaxime after i. v. drip infusion revealed a same trend after i. v. injection. Urinary concentration and urinary recovery were directly related. Cefotaxime was effective in 92. 5% of 80 patients, consisting of 61 mature and 19 premature infants. Responder rates by the main indications treated were 100% in 19 cases of meningitis, 81.8% in 11 cases of septicemia, 88. 0% in 25 cases of respiratory tract infection, 100% in 5 cases of urinary tract infection, 100% in 3 cases of SSS syndrome, and 100% in 4 cases of phlegmon. Forty-six pathogens were isolated from 38 patients. Excluding 4 strains for which the bacteriological response was inassessable, the eradication rate against the remaining 42 strains was 78. 6%. All 6 strains of Group B Streptococcus were isolated from patients with meningitis. Cefotaxime was both clinically and bacteriologically effective in all of these cases. Cefotaxime was effective in 20 (90.9%) of 22 patients with infections refractory to other antibiotics. Diarrhea, skin rash, elevations of GOT, GPT and LDH, and leukopenia were noted in several cases, but none of these adverse reactions were problematic. Diarrhea and skin rash occurred mainly in nursing infants. Fundamental and clinical studies of cefotaxime were carried out in mature and premature infants requiring antibiotic treatment. Cefotaxime was demonstrated to be a useful antibiotic for the treatment of infections in neonates.
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