Antimicrobial Susceptibility Tests with Cefotaxime and Correlation with Clinical Bacteriologic Response

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Abstract
Cefotaxime is a new cephalosporin with a wide spectrum of antimicrobial activity. For broth and agar dilution tests, the MIC breakpoints suggested for defining bacterial susceptibility are ⩽8 µg/ml for susceptible, 16–32 µg/ml for moderately susceptible (indeterminate), and >32 µg/ml for resistant. For disk diffusion tests, the zone diameter breakpoints suggested are ⩾23 mm for susceptible, 15–22 mm for moderately susceptible, and ⩽ 14 mm for resistant. Examination of the bacteriologic outcome of infection for 1,440 patients treated with cefotaxime shows that the results of disk diffusion tests correlated well with clinical response. The organisms that had cefotaxime disk zones of ⩾23 mm were eradicated in 89% of cases. Clinical response of urinary tract infections due to Pseudomonas aeruginosa was unrelated to disk results for bacterial isolates; the rate of bacteriologic cure was 55%–64% regardless of category. It is further recommended that cefotaxime and other cephalosporins not be tested against the enterococci.

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