Cefotaxime and cephalosporins: adverse reactions in perspective.

Cefotaxime was used to treat infections in 2,579 patients during phase II and phase III clinical trials. This paper summarizes the adverse reactions reported to Hoechst-Roussel Pharmaceuticals (Somerville, NJ) during the treatment of these infections. Cefotaxime caused adverse reactions that are caused by all other cephalosporins, including pain at the site of injection (31.9%), thrombophlebitis (4.9%), skin rash (1.8%), thrombocytopenia (3.8%), glomerulotubular dysfunction (1.4%), diarrhea (1.2%), and superinfection (1.1%). Compared with cefazolin, cefotaxime caused pain on injection, phlebitis, and diarrhea more commonly (P less than 0.05) but caused superinfection less commonly (P less than 0.04). Since these data were obtained from many different sources by diverse methods, further controlled trials are needed to substantiate these differences. However, the adverse reactions caused by cefotaxime appear to be similar in spectrum and severity to those caused by other cephalosporins.