title: In vitro activity of cefepime, a new parenteral cephalosporin, against recent European blood isolates and in comparison with piperacillin/tazobactam.
abstract: Cefepime, a new parenteral cephalosporin with broad antibacterial spectrum and stability to the hydrolysis to many bacterial beta-lactamases, was tested against recent blood culture isolates (369 strains of gram-negative bacilli and 131 strains of staphylococci) collected in 29 European laboratories by the microdilution method in Mueller-Hinton broth. Cefepime was very active against the gram-negative bacilli (MIC50 less than or equal to 0.016-0.064 mg/l; MIC90 0.064-4 mg/l) and less active against Pseudomonas (MIC50 4 mg/l; MIC90 greater than 16 mg/l) or Acinetobacter (MIC50 and MIC90 greater than 16 mg/l). The staphylococci were also inhibited (MIC50 8 mg/l; MIC90 16 mg/l). Cefepime was very active against bacteria producing different plasmid-encoded beta-lactamases (MIC 0.016-0.5 mg/l). Piperacillin was not active against the latter strains (MIC from 2 to greater than 64 mg/l), but the presence of the beta-lactamase inhibitor tazobactam restored the activity of piperacillin. The bactericidal activity of cefepime and piperacillin/tazobactam against beta-lactamase-producing strains was confirmed by the killing curve technique.
authors.affiliation: Department of Clinical Microbiology, Karolinska Hospital, Stockholm, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Dornbusch
authors.forename: E
authors.initials: E
authors.lastname: Mörtsell
authors.forename: E
authors.initials: E
authors.lastname: Göransson
mesh_terms: D000077723:Cefepime; D002511:Cephalosporins / Q000378:metabolism / Q000494:pharmacology*; D004352:Drug Resistance, Microbial; D004357:Drug Synergism; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000201:enzymology; D008826:Microbial Sensitivity Tests; D010397:Penicillanic Acid / Q000378:metabolism / Q000494:pharmacology*; D010403:Penicillin Resistance; D010878:Piperacillin / Q000378:metabolism / Q000494:pharmacology*; D013210:Staphylococcus / Q000187:drug effects* / Q000201:enzymology; D000078142:Tazobactam; D065093:beta-Lactamase Inhibitors; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D002511:Cephalosporins; D065093:beta-Lactamase Inhibitors; D000077723:Cefepime; D010397:Penicillanic Acid; D001618:beta-Lactamases; D000078142:Tazobactam; D010878:Piperacillin