Cefotaxime therapy. Evaluation of its effect on bacterial meningitis, CSF drug levels, and bactericidal activity

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Abstract
Cefotaxime sodium was evaluated in the treatment of 10 patients with bacterial meningitis. Of the patients, 7 were infected with unusual and difficult to eradicate pathogens; 8 of the 10 patients had a favorable clinical response and rapid sterilization of their CSF. Trough CSF levels of cefotaxime (range, 5.6-44.3 .mu.g/ml) and desacetylcefotaxime (3.7-44.0 .mu.g/ml) were many-fold greater than the minimal bactericidal concentrations of the causative pathogens with the exception of the 1 Pseudomonas aeruginosa isolate. Trough CSF bactericidal titers ranged from 1:16-1:4096 or more (median, 1:256) in the 9 patients with susceptible pathogens. Trough cefotaxime and desacetylcefotaxime levels and bactericidal titers were maintained or actually increased over the course of therapy. Cefotaxime appears to be a promising new agent for the treatment of bacterial meningitis.

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