Cefepime/Sulbactam — A New Innovative Antibiotic for In-Hospital Treatment of Severe Infections and the Implementation of Carbapenem-Replacement Strategy to Contain Antibiotic Resistance

Cefepime/sulbactam is a combined antibiotic consisting of the 4 th generation cephalosporin cefepime and beta-lactamase inhibitor sulbactam in 1:1 ratio. was developed Russia 2006, it had passed preclinical clinical studies, approved for medical use, has been produced since 2019. Cefepime wide spectrum antimicrobial activity against gram-positive gram-negative microorganisms, adds two clinically important pathogens to — Acinetobacter baumannii Bacteroides fragilis . In addition, protects from hydrolysis by class A broad- extended-spectrum beta-lactamases, itself stable C chromosomal beta-lactamases partially OXA-type D carbapenemases. vitro studies have shown that most strains ESBL-producing Klebsiella pneumoniae , Escherichia coli Proteus spp. are sensitive cefepime/sulbactam, as well some K.pneumoniae A.baumannii resistant carbapenems result production The efficacy safety cefepime/sulbactam determined three studies. Clinical bacteriological drug 97.9% 97.6% patients with acute community-acquired pyelonephritis. MAXI-19 multicenter study, intra-abdominal infections, nosocomial pneumonia, ventilator-associated pneumonia 78.4, 90.3, 80.7%, respectively. comparative study examined severe infections (84% sepsis or septic shock). high did not significantly differ (71% vs. 62%), 87% 73%, while typical hospital characterized MDR XDR were identified majority (most often E.coli ). During treatment carbapenems, carbapenem-resistant bacteria detected more (74.5%, 44.7%, 38.3%), compared (20.0%, P.aeruginosa both at 15.5%), P=0.0001. risk superinfection also higher than (53.3% 22.2%, P=0.001). For administered dose g (2 + 2 g) every 12 hours (1 1 8 hours. Currently, should be considered reliable option carbapenem-replacement strategy reduce risks selection bacteria.