[Evaluation of ceftriaxone (R013-9904) in the treatment of septicemia caused by gram-negative bacilli].

Thirty-four patients admitted for a suspicion of septicaemia were treated with ceftriaxone, a third generation cephalosporin. Ceftriaxone was administered IV at a dose of 2 grams daily, either as a single injection of 2 g or as two injections of 1 g each. 43 organisms were isolated from the blood of the 34 patients: 20 E.coli; 5 Klebsiella; 2 Salmonella; 2 indole positives Proteus; 1 indole negative Proteus; 1 Enterobacter; 2 Acinetobacter; 3 Staphylococcus aureus; 2 Streptococcus; 1 Enterococcus; 1 Meningococcus and 3 anaerobes. The MIC of the enterobacteria for ceftriaxone ranged from less than or equal to 0.097 microgram/ml to 1.56 microgram/ml. Only two staphylococci, one Acinetobacter and the enterococcus were resistant to the drug. Serum assays of ceftriaxone were performed on the second day of treatment for 15 patients. Within the group treated with a single dosis of 2 g per day, the blood levels were: maximal level (10 min, after the injection): 175 to 460 micrograms/ml (average: 315), minimal level (before injection) 12 to 100 micrograms/ml (average 53). Among the patients treated with two doses of 1 g per day, we obtained: maximal levels 121 to 260 micrograms/ml (average 178), minimal levels 31 to 70 micrograms/ml (average 52). A clinically favorable evolution was obtained for 29 patients (85%). In the cases of 4 patients, the antibiotherapy had to be adapted in view of the susceptibility of the organisms isolated. Ceftriaxone was very well tolerated. The only observed secondary effect was a drug fever occurring in 3 patients who remained febrile in spite of a general improvement.