Activity of cefotaxime against enterococci.

The third-generation cephalosporins as a group are characterized by spectra of activity that are the broadest of the currently available antibiotics (Farber and Moellering, 1982). These agents provide excellent coverage of infections due to Enterobacteriaceae. They also exhibit good (but variable) activity against a number of "nonfermentors" such as Pseudomonas aeruginosa, and many of them are likewise active against anaerobes, including Bacteroides fragilis (Farber and Moellering, 1982). As a class, the third generation cephalosporins are less active against gram-positive organisms, but in spite of this they have been clinically effective against infections due to S. aureus and many other gram-positive cocci (Saito, 1982). Enterococci, however, have proven to be a difficult organism for the third-generation cephalosporins. None of the presently available compounds exhibits very good activity against these organisms in vitro (Fass, 1983). Given this fact and the broad spectrum of activity of these compounds against other organisms, there is a significant potential for enterococcal superinfection in patients treated with the third-generation cephalosporins. Indeed, serious enterococcal infection has clearly been documented in patients treated with some third-generation cephalosporins (Moellering, 1982; Yu, 1981). Although none of the presently available third-generation cephalosporins exhibits therapeutically useful activity against enterococci, currently available data suggest that there may be differences among these compounds in their ability to cause (or prevent) this complication. For instance, there are more published reports of enterococcal superinfection in patients treated with moxalactam than in patients receiving the other third-generation cephalosporins.(ABSTRACT TRUNCATED AT 250 WORDS)