COMPARISON OF CEFTRIAXONE AND CEFOTAXIME IN SEVERE PEDIATRIC BACTERIAL-INFECTION - A MULTICENTRIC STUDY

319 children with clinical data indicating a probably severe bacterial infection were randomly studied during 9 months in 33 French center. They were treated either with a single daily injection of ceftriaxone at 50 mg/kg/d (100 mg/kg/d for meningitis or typhoid fever) or with 3 to 4 injections of cefotaxime at 100 to 200 mg/kg/d. An aminoglycoside or an imidazole compound could be used as associated therapy accordin g to the severity of infection as well as ampicillin in neonates. The clinical severity criteria and the biological parameters (PCR) were as sessed before antibiotic treatment. 233 cases were selected for the co mparative study: 22 new-borns, 117 infants, 94 children. 118 were give n ceftriaxone and 115 cefotaxime. The infections were documented for 2 21/233 patients (95 %): E. coli (54 %). H. influenzae (14 %). N. menin gitidis (6 %), Proteus mirabilis (3,5 %), S. pneumoniae (6 %), Strepto cocci (2.6 %). Pseudomonas (2.2 %) Enterobacter (1.7 %). Salmonella ty phi (6.7 %). miscellaneous (3.3 %). The infections treated were pyelon ephritis (131), meningitis (36), septic fever (35), and other infectio ns (31). The groups were comparable in age and sex. Results showed no difference for efficacity or bacterial eradication, in any pathology. Tolerance was excellent for the two groups, adverse reactions were rar e: 9 for the ceftriaxone group, 10 for the cefotaxime group (no signif icant difference). The total dose (mg/kg x days of treatment) of cefot axime was three time higher than the total dose of ceftriaxone used. T his trial stressed thr easier management and the potential lower cost of ceftriaxone, thanks to 3 single daily administration.