Young L S
Kuzell Institute, San Francisco, USA.
Diagn Microbiol Infect Dis. 1995 May-Jun;22(1-2):147-54. doi: 10.1016/0732-8893(95)00103-h.
Cefotaxime, the first widely used "third-generation" cephalosporin, has established efficacy against a variety of serious bacterial pathogens. Some of the initial clinical studies in the United States using this agent employed large doses of the compound, up to 12 g/day, for adults. In contrast, however, initial European studies were largely with low doses of 1 to 2 g every 12 h. In the recent past, however, an effort has been made, both in the United States and in Europe to reevaluate the dosage of cefotaxime. In various clinical studies, lower doses of cefotaxime have been successfully employed for infections of the urinary tract, peritoneum, biliary tract, lung, and skin and soft tissues. The results of a number of these studies will be reviewed, including a large postmarketing surveillance study carried out in Germany during 1992. The results suggest that cefotaxime doses as low as 1 g, at intervals as long as every 12 h, can be adequate for treatment of the most commonly encountered infections, such as those caused by some hemolytic streptococci, Staphylococcus aureus, Haemophilus spp., and enteric bacilli in nonimmunocompromised patients.
头孢噻肟是第一种被广泛使用的“第三代”头孢菌素，对多种严重细菌病原体均有确切疗效。美国最初使用该药物的一些临床研究中，成年患者使用的化合物剂量高达每天12克。然而，相比之下，欧洲最初的研究大多采用每12小时1至2克的低剂量。不过，最近美国和欧洲都在努力重新评估头孢噻肟的剂量。在各种临床研究中，较低剂量的头孢噻肟已成功用于治疗泌尿系统、腹膜、胆道、肺部以及皮肤和软组织感染。将对其中一些研究的结果进行综述，包括1992年在德国进行的一项大型上市后监测研究。结果表明，对于非免疫功能低下患者中最常见的感染，如由某些溶血性链球菌、金黄色葡萄球菌、嗜血杆菌属和肠道杆菌引起的感染，每12小时一次、低至1克的头孢噻肟剂量可能就足够了。
