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Evaluation of ceftazidime in the treatment of severe bacterial infection.

We investigated the clinical efficiency and safety of ceftazidime for treatment of 33 episodes of infection in 30 patients (17 males and 13 females), whose ages ranged from 9 to 92 years (mean 52.5). Fourteen patients had ultimately fatal disease and the remaining 16 had non-fatal diseases. The clinical condition of patients at the beginning of treatment was critical or poor in 16 cases. Episodes of infection treated were: 24 urinary tract infections (eight of them with concomitant bacteraemia), seven wound infections (one with concomitant bacteraemia and three with osteomyelitis), and two episodes of pneumonia. Twenty-nine episodes of infection were monomicrobial and the four remaining ones were polymicrobial. Significant organisms isolated were all aerobic or facultatively anaerobic Gram-negative rods and were responsible for the following episodes of infection: Escherichia coli (14), Pseudomonas aeruginosa (12), Pseudomonas cepacia (1), Proteus mirabilis (5), Serratia marcescens (2), Klebsiella (2), Enterobacter aerogenes (1) and Haemophilus influenzae (1). Total dosage of ceftazidime ranged from 28 to 240 g (mean 82.4 g), and mean duration of therapy was 17 days (range 8 to 44 days). The overall rate of clinical response to ceftazidime was 91%. Local and general tolerance to the drug was excellent. Enterococcal and/or candida colonization occurred in 12 episodes (36%) and superinfections by the same micro-organisms occurred in three episodes. Ceftazidime seems to be an effective and safe single agent for therapy of many bacterial infections, including those caused by Ps. aeruginosa.