Activity of Cefotaxime versus Ceftriaxone against Pathogens Isolated from Various Systemic Infections: A Prospective, Multicenter, Comparative, In vitro Indian Study

Abstract

Objectives To determine the susceptibility of isolated pathogens with different samples collected from patients taking cefotaxime as compared with ceftriaxone.

Methods In vitro susceptibility study was conducted at microbiology laboratories of east (Bhubaneshwar), west (Ahmedabad), north (Delhi), and south (Srikakulam) India. Samples of treatment naïve patients with various clinical infections were included if they were positive for bacterial culture. Minimum inhibitory concentration (MIC) and zone of inhibitions (ZoIs) for each isolate were determined using Ezy MIC strip test and disk diffusion methods, respectively. Findings of MIC and ZoI were interpreted as per the Clinical and Laboratory Standards Institute guidelines. Appropriate statistical tests were used.

Results Four hundred clinical samples of urinary tract infection (42.75%), lower respiratory tract infection (20.75%), skin and soft tissue infection (16.75%), and sepsis (12.75%) were evaluated. Escherichia coli (47.75%) was the most common organism isolated followed by Klebsiella (26%), Salmonella (7.75%), and Proteus mirabilis (3.75%). The mean MIC values for E. coli, Klebsiella, Staphylococcus, Citrobacter koseri, and Serratia marcescens were found to be lower when treated with cefotaxime compared with ceftriaxone, although the difference was not statistically significant. However, cefotaxime produced significantly (p < 0.05) more ZoI for E. coli, Klebsiella, and Salmonella as compared with ceftriaxone.

Conclusion Cefotaxime has shown better sensitivity profile in terms of MIC and ZoI to most of the isolated organisms as compared with ceftriaxone and thus can be preferred for empirical treatment of such patients.