Experience with cefotaxime in infections caused by gram-positive pathogens, especially Staphylococcus aureus.

Cefotaxime (CTX) was the first third-generation cephalosporin to be launched. According to my classification of cephalosporins for practitioners, in contrast to old beta-lactamase-labile cephalosporins (Group I-III), CTX is beta-lactamase-stable and belongs to Group V with anti-pseudomonas activity. A critical review of about 90 patients with Staphylococcus aureus infections, found among analyzable subjects treated with CTX for gram-positive infections, demonstrates that CTX can be expected to be bacteriologically and clinically effective against this pathogen. Moreover, CTX had excellent efficacy against gram-positive organisms compared with other so-called third-generation cephalosporins. CTX is comparable to or more effective than conventional antibiotics in the treatment of respiratory tract infections, soft tissue infections, and neonatal and pediatric infections caused by gram-positive organisms, S. aureus included, if used after taking the susceptibility of the pathogen into account.