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Cefotaxime (100 mg once a day, with meals)
Doxycycline (5 mg/kg IV)
Voriconazole (20 mg/kg, IV)
Ofloxacin (100 mg 2×/day)
Ibuprofen (5 g intravenously), acetaminophen, and caffeine (500 mg PO/kg) was added
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Results
Pneumothorax and pulmonary artery block were noted in 1 patient. The other 8 patients were free of signs pneumothorax or pulmonary artery block. There were no serious adverse events reported. The patient found to have septicemia was discharged after antibiotic treatment. She had no neurological deficit after discharge.
Conclusion
The results of this review suggest that cefotaxime is a safe treatment for pneumonia. The most common adverse reactions were fatigue (15.5%) and rash (10.2%) but only 4.4% discontinued because of these adverse effects.
Cefotaxime is an excellent choice (i.e. lower volume, longer duration and dose) for patients with primary pulmonary disease (including COPD). Cefotaxime is a good choice for the treatment of patients who have primary pulmonary disease. It can also be used for secondary bacterial pneumonia.
Ceftriaxone is an excellent choice for patients with secondary bacterial pneumonia, especially in the setting of COPD. authors suggest that this treatment may not be the best choice for patients with bacterial pneumonia or primary pulmonary disease due to other reasons.
There are no clinical trials to date compare cefotaxime with other antibiotics. This review supports the clinical decision that most likely, all other antibiotics should be used at a lower dose. The authors believe that there is likely no clinical evidence to support treating anaphylaxis with cefotaxime.
The authors note that clinical evidence does not support the use of cefotaxime in patients with systemic lupus erythematosus or in patients with acute renal failure.
This review demonstrates that cefotaxime is as effective other antibiotics in the treatment of pulmonary infection, such as bronchitis.
This drug should NOT be given for more than 6 weeks if there is signs of fever (fever > 37.0°C) or pneumonia.
Antibiotics should NOT be used in patients that are suffering severe liver or kidney failure.
When cefotaxime is added to the antibiotic therapy for patients with acute bronchitis, it may not be required to decrease the dose of antibiotic. This treatment should usually be reserved for patients with severe bronchitis and pneumonia, who require the antibiotics for less than 2 weeks.
References
O'Connor MJ, Jones SJ, AM, et al. The effect of Cefotaxime for primary pulmonary infection. N Engl J Med 1983; 311; 1150-6. Stoddert JS, Epps A, Van Reeth S, et al. Cefotaxime in the treatment of pneumococcal infection in children: a double blind randomized controlled trial. N Engl J Med 2010; 363:2129-34. [ PUBMED ] FULLTEXT
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