Effective empiric treatment of pneumonia requires antibiotic coverage against gram-negative and grampositive pathogens, including drug-resistant isolates. We compared the safety and efficacy of intravenous (i.v.) cefepime (2 g administered every 12 h) to those of i.v. ceftriaxone (1 g administered every 12 h) for the empiric treatment of hospitalized patients with community-acquired pneumonia. ...

The patient is a 54-year-old man with severe thermal burn injury involving 45.5% of the total body-surface area, complicated with bacteremia caused by Pseudomonas aeruginosa with a cefepime MIC of 8 µg/ml. The plasma concentrations of cefepime 1 g every 6 h measured by validated high performance liquid chromatography were 25.8 µg/ml at 1 h and 6.28 µg/ml at 5 h after infusion, and 3.9 µg/ml bef...

Heteroresistance to antimicrobial agents may affect susceptibility test results and therapeutic success. In this study, we investigated heteroresistance to cephalosporins and penicillins in Acinetobacter baumannii, a major pathogen causing nosocomial infections. Two A. baumannii isolates exhibited heteroresistance to ampicillin-sulbactam, ticarcillin-clavulanic acid, cefepime, and cefpirome, sh...

Antibiotic restriction can be useful in maintaining bacterial susceptibility. The objective of this study was verify if restriction of cefepime, the most frequently used cephalosporin in our neonatal intensive care unit (NICU), would ameliorate broad-spectrum susceptibility of Gram-negative isolates. Nine hundred and ninety-five premature and term newborns were divided into 3 cohorts, according...

Encephalopathy or neurotoxicity can occur with cefepime use in patients with impaired or relatively normal renal function. However, few articles have examined the relationship between cefepime's adverse effects and peritoneal dialysis. Here, we report the case of an 80-year-old woman with chronic renal failure on peritoneal dialysis that developed agitation, confusion, and dystonia after cefepi...

A multicenter, open labelled, randomized study was carried out to compare the prophylactic efficacy of Cefepime and Ceftriaxone in patients undergoing biliary tract surgery. Two hundred and nine patients were included in the study and randomized to receive preoperative infusion of 2 g Cefepime (n=107) or 2 g Ceftriaxone (n=102) both in a single i.v. administration. Antimicrobial prophylaxis was...

Cefepime is a broad-spectrum, fourthgeneration cephalosporin originally approved by the US Food and Drug Administration (FDA) in 1996 for treatment of bacteremia, pneumonia, and other serious conditions and 1 year later as monotherapy in the empiric treatment of patients with fever and neutropenia. In the years after its approval, most physicians became confident of both the efficacy and safety...

1. Chow KM, Hui AC, Szeto CC. Neurotoxicity induced by b-lactam antibiotics: from bench to bedside. Eur J Clin Microbiol Infect Dis 2005; 24: 649–53. 2. Yahav D, Paul M, Fraser A et al. Efficacy and safety of cefepime: a systematic review and meta-analysis. Lancet infect Dis 2007; 7: 338–48. 3. Dixit S, Kurle P, Buyan-Dent L et al. Status epilepticus associated with cefepime. Neurology 2000; 54...

Cefepime is a fourth-generation B-lactam cephalosporin, commonly used in immunosuppressed patients. Neurotoxicity, which present as nonconvulsive status epilepticus (NCSE), has been reported previously especially in adult patients with impaired renal function. We present a case of cefepime induced NCSE after recovering from acute renal failure. A 71-year-old woman was hospitalized for right low...