Clinical applications of a new parenteral antibiotic in the treatment of severe bacterial infections
- 24 June 1996
- journal article
- clinical trial
- Published by Elsevier BV in American Journal Of Medicine
- Vol. 100 (6), 52S-59S
- https://doi.org/10.1016/s0002-9343(96)00108-8
Abstract
Cephalosporins are one of the mainstays of antibiotic therapy, and third-generation cephalosporins are first-line agents for the treatment of many types of serious infections, including those of nosocomial origin. Gaps in activity of currently available third-generation cephalosporins such as cefotaxime, cefoperazone, ceftriaxone, and ceftazidime, and increasing reports of gram-negative bacilli resistance to some of these agents, especially Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterobacter spp., make it necessary to investigate new compounds. Cefepime, a fourth-generation cephalosporin with a wide range of activity against gram-positive and gram-negative bacteria, including multi-resistant strains of Enterobacteriaceae, was evaluated in comparison with ceftazidime for the treatment of serious infections in hospitalized patients. Ceftazidime is a commonly prescribed third-generation cephalosporin used for empiric treatment of serious infections such as pneumonia, urinary tract infection, and skin and skin-structure infection. This investigation was an open, randomized comparative study involving 882 patients in North America. Cefepime 2 g every 12 hours demonstrated similar efficacy to that of ceftazidime 2 g every 8 hours for the treatment of pneumonia and urinary tract infection (including cases associated with concurrent bacteremia), and skin and skin-structure infections. The bacteriologic responses were generally >85%. The most common pathogens isolated were Escherichia coll, Streptococcus pneumoniae, P. aeruginosa, K. pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Streptococcus, group B. Overall, approximately 94% of pathogens isolated in pretreatment cultures were susceptible to cefepime and ceftazidime. Cefepime and ceftazidime were well tolerated; only 3% of patients in each group discontinued therapy because of an adverse event. The most common adverse events were headache, diarrhea, nausea, vomiting, pruritus, and rash. The results of this study indicate that cefepime is a promising, effective, and safe single-agent therapy for serious infections in hospitalized patients.Keywords
This publication has 20 references indexed in Scilit:
- Prevalence of important pathogens and antimicrobial activity of parenteral drugs at numerous medical centers in the United States I. Study on the threat of emerging resistances: Real or perceived?Diagnostic Microbiology and Infectious Disease, 1994
- Improved Outcome of Staphylococcus aureus BacteremiaInfectious Diseases in Clinical Practice, 1994
- Gram-positive Organisms and SepsisArchives of Internal Medicine, 1994
- Genetics of extended-spectrum beta-lactamasesEuropean Journal of Clinical Microbiology & Infectious Diseases, 1994
- Cefepime: overview of activity in vitro and in vivoJournal of Antimicrobial Chemotherapy, 1993
- In-vitro antibacterial activity of cefepime: a multicentre studyJournal of Antimicrobial Chemotherapy, 1993
- In-vitro activity of cefepime and other antimicrobials: Survey of European isolatesJournal of Antimicrobial Chemotherapy, 1993
- Major trends in the microbial etiology of nosocomial infectionAmerican Journal Of Medicine, 1991
- Pathophysiologic basis for the use of third-generation cephalosporinsAmerican Journal Of Medicine, 1990
- Urinary Tract Infections in Women: Diagnosis and TreatmentAnnals of Internal Medicine, 1989