­­­­­Cefotaxime: A reappraisal for use in lower respiratory tract infections

Abstract

Lower respiratory tract infections (LRTIs) are documented to cause significant morbidity and mortality in patients worldwide. During the ongoing pandemic, LRTIs like pneumonia are posing a major health concern for patients and the healthcare system. In COVID-19-related pneumonia bacterial co-infection is not uncommon and remains a leading cause of mortality in affected cases. Cefotaxime, a third-generation parenteral cephalosporin, has a broader spectrum of antimicrobial activity with a high-level of stability against β-lactamases. Despite many years of clinical usage for cefotaxime in LRTIs, resistance to this drug does not seem to be a major concern, and it is still one of the cornerstones in the choice effective antimicrobial therapy. This paper attempts to delineate available evidence for cefotaxime usage in various clinical situations like community acquired pneumonia (CAP), nosocomial pneumonia, acute exacerbations of chronic bronchitis (AECB) and acute bronchitis. This may be of help for a clinician to develop a thorough viewpoint on the rational use of this time-tested antimicrobial agent and to take an apt clinical decision towards the optimum patient care.